High fetal duodenal obstruction refers to a group of common prenatal ultrasound findings of “double bubble sign” in the fetal abdomen, including duodenal atresia, congenital intestinal rotational insufficiency and cricothyroid pancreas, which are intrinsic or extrinsic causes of duodenal inability to pass and obstruction. However, the subsequent management is more confusing. Our current management criteria are: Diagnosis: After 18 weeks of gestation, the diagnosis is confirmed by two or more prenatal ultrasound findings of double vesicles with excessive amniotic fluid. Special emphasis: when the diagnosis is confirmed the most important thing is to check the chromosomes of the fetus, because 15% – 30% will have combined chromosomal abnormalities, usually trisomy 21, trisomy 18, etc. Treatment: When all other abnormalities have been ruled out, the baby can be considered. Preterm delivery will occur in 20% of cases because there is excess amniotic fluid. Treatment is usually chosen in the postnatal period. A combined thoracoabdominal film is required after birth, which shows the typical double bubble sign in the upper abdomen and little or no air in the rest of the abdomen, to confirm the diagnosis and require subacute surgery.