Objective To analyze the correlation between referral indications for fetal echocardiography and prenatally detected fetal cardiac abnormalities. Methods 1 032 pregnant women referred for fetal echocardiography were retrospectively analyzed. All referral cases were assigned to singleindication and multiindication groups. The distribution of referral indications was analyzed, the rate of prenatally detected fetal cardiac abnormalities was obtained, and the correlation between referral indications and prenatally detected fetal cardiac abnormalities was assessed. Results In the singleindication group, 172 cases of fetal cardiac abnormalities (19.4%) were detected in 885 referral cases. Logistic regression analysis demonstrated that suspected cardiac views detected by routine second trimester fetal malformation screening were associated with prenatally diagnosed fetal cardiac abnormalities (OR=13.7; 95%CI=9.40-20.00). Isolated strong intracardiac echogenic foci were negatively correlated to prenatally detected fetal cardiac abnormalities (OR=0.24; 95%CI=0.11-0.56). The rate of prenatally detected fetal cardiac abnormalities increased to 27.2% (P=0.336) in the multiindication group. For cases with fetal indication, the risk of prenatally detected fetal cardiac abnormalities significantly increased. Conclusion As an isolated referral indication, suspected cardiac views detected by routine second trimester fetal malformation ultrasound screening are associated with prenatally detected fetal cardiac abnormalities, while isolated strong intracardiac echogenic foci should no longer serve as a referral indication for fetal echocardiography. For pregnant women with multiple referral indications for fetal echocardiography, if one of them is fetal indication, the rate of prenatally detected fetal cardiac abnormalities will be much higher.