Objective: To compare the diagnostic accordance rate between prenatal ultrasonography and fetal magnetic resonance imaging (MRI) for varied neural tube defects (NTDs), and introduce detailed prenatal imaging characteristics of multiple NTDs. Design: A prospective observational study Setting: Chinese PLA General Hospital Population: The fetuses developing possible NTDs. Method: We prospectively followed up the fetuses and collected their data of prenatal ultrasonography, fetal MRI, and postnatal MRI examinations. Fisher’s exact test was used to perform the statistical analysis. A P value of < 0.05 was considered statistically significant. Main Outcome Measures: The diagnostic accordance rate of prenatal ultrasonography and fetal MRI for each involved NTD, prenatal imaging characteristics of each involved NTD. Results: We included 119 fetuses with 11 NTDs. Ultrasonography revealed a significant advantage in diagnosing spina bifida (P < 0.05) and a relative advantage in diagnosing intraspinal cyst, dermal sinus, and skin mass. MRI demonstrated intraspinal lipoma better (P < 0.05), and was appropriate for identifying complex malformations. Both could accurately diagnose tethered cord syndrome (without intraspinal lesions), meningocele/myelomeningocele, and sacrococcygeal teratoma. Conclusions: Prenatal ultrasonography and fetal MRI have different advantages in diagnosing NTDs. To ensure a prompt and accurate diagnosis, it is crucial for clinicians to raise awareness of the prenatal imaging characteristics of various NTDs, which will lay a solid foundation for better fetal prognosis. Funding: This study was supported by the Capital’s Funds for Health Improvement and Research (CFH2022-2-5022). Keywords: prenatal ultrasonography, fetal magnetic resonance imaging, neural tube defects, pregnancy, diagnosis, fetus