Ultrasound and Doppler imaging have proven to be valuable antepartum diagnostic tools for the early recognition of vasa previa. Recent reports have demonstrated that successful detection and timely management can subsequently reduce the risk of a life-threatening fetal hemorrhage. We present the fourth reported case of vasa previa detected antenatally by ultrasound. While conscientious attention to the risk factors and a high index of clinical suspicion remain important considerations, we believe that ultrasound and color Doppler flow analysis represent a highly sensitive diagnostic tool for those patients at risk. In the past, antenatal diagnosis has relied on insensitive and inconclusive means, often only after signs of fetal compromise have become apparent. Sonography has been demonstrated to offer reduced fetal mortality and therefore must be considered the new standard of care for management of suspected vasa previa.