Vasa praevia can have the catastrophic consequences of a fetal or neonatal death. There are few antenatal diagnoses whereby ultrasound can have such a direct impact on outcome and dramatically increase the chances of survival in pregnancies affected by this condition. The exclusion of vasa praevia can take under a minute and its inclusion within the routine anomaly scan should be prioritised. Until this occurs, healthy babies will continue to die due to this condition. © British Medical Ultrasound Society 2008.