Taking advantage of advanced prenatal imaging, we can now identify many heart problems, including hypoplastic left-heart syndrome (HLHS), during pregnancy. When families first learn about a diagnosis of HLHS, they often feel overwhelmed, but early diagnosis allows us to provide comprehensive prenatal counseling and a neonatal surgical plan. In some patients with aortic stenosis and evolving HLHS, fetal cardiac intervention (FCI) may be an option to prevent a progression to HLHS. After birth, Boston Children's heart surgeons perform innovative surgeries to treat HLHS and borderline left-heart concerns.