Fetal unseen gastric vesicle may be a normal manifestation of pregnancy, or it may be caused by pathological reasons, such as fetal esophageal atresia, abnormal maxillofacial development, etc., which requires timely termination of pregnancy. The content of gastric vesicle in fetal period is usually amniotic fluid swallowed by the fetus, which can be shown as anechoic area under ultrasonography. Since the swallowing function of the fetus will appear around the end of 20 weeks of gestation, premature ultrasonography may result in unseen gastric vesicle in the fetus, which is a normal manifestation, and there is no need for special treatment, and timely rechecking can be done. Some fetuses still cannot show gastric vesicles after 20 weeks of gestation, accompanied by excessive amniotic fluid, which suggests that the swallowing function of the fetus is impaired, most commonly seen in fetal esophageal atresia, maxillofacial developmental anomalies, central nervous system disease, etc., and the diagnosis should be terminated in a timely manner. There are many reasons that may lead to fetal gastric vesicles are not shown, patients should go to the hospital in time to clarify the cause of the disease, if necessary, timely treatment, so as not to lead to adverse consequences.