Fetal repair of open neural tube defects, including myelomeningocele, improves postnatal outcomes. This procedure reduces the severity of hydrocephalus and consequently the need to divert cerebrospinal fluid. It also improves motor functions and increases the chances of walking independently by 30 months. These benefits were demonstrated in the 2011 Management of Myelomeningocele Study (MOMS). Based on these findings, surgery became part of standard care. Today it is offered in many centers around the world. The paper marks the first of these steps in a potential new era of fetal intervention for spina bifida.