Fetal cardiac intervention consists of a novel and evolving technique for the intrauterine treatment of a subset of patients with congenital heart diseases, which aims to improve hemodynamics, reduce secondary damage, and achieve better postnatal outcomes. Nevertheless, the risks and benefits of this therapy remains subject to controversy. This review describes the rationale, selection criteria, and technical features for the most frequently performed fetal cardiac interventions. In addition, we provide a comprehensive overview of the medical literature, exploring the clinical implications of each therapy.