Fetal pleural effusion is found in 32 weeks of pregnancy, according to the severity of pleural effusion, follow-up observation, thoracentesis, termination of pregnancy and other treatment options. Fetal pleural effusion refers to excessive accumulation of fluid in the pleural cavity, which is a relatively common fetal disease in clinical practice. The cause of pleural effusion should be further examined, and the treatment should be targeted according to the severity of pleural effusion. Fetal pleural effusion is categorized into primary fetal pleural effusion and secondary pleural effusion. Primary pleural effusion has a small amount of fluid and does not require special treatment as long as it is regularly observed and followed up. Fetuses with more pleural effusion and older than 32 weeks of gestational age, under the condition of establishing intravenous access and ensuring systemic circulating blood volume, can be performed thoracentesis after birth and closely observed. Secondary to fetal pleural effusion, further examination by amniocentesis is required to determine whether the fetus has any chromosomal abnormalities, such as trisomy 21, trisomy 18, etc., and then detailed ultrasonography is required to determine whether the fetus has any cardiovascular malformations or other structural malformations, and termination of pregnancy is necessary to deal with the abnormalities when the results of the examination are abnormal. Fetal pleural effusion is detected at 32 weeks of pregnancy, and the intrauterine development of the fetus is promptly examined and clarified before deciding on the way of further treatment.