Objective To evaluate the clinical application of combining functional MRI and optimized structural MRI on clinical diagnosis of fetal brain abnormities. Methods 89 subjects (prenatal gestational woman and corresponding postnatal neonate) who have received a prenatal ultrasound examination (US), prenatal MRI examinations and postnatal neonate MRI examinations were enrolled in this study. MRI scan protocols include general structural imaging (2D T2W-TSE and 3D T1W-TFE/2D T1W Balance TFE) and functional imaging (DWI and optional SWI). Results The prenatal US and prenatal MRI techniques were evaluated by comparing the examination results with postnatal neonate MRI. test results showed that the there is a significant difference between them. The MRI examinations of fetuses with abnormal structures showed that 42 (56.0%) fetuses diagnosis results were consistent between prenatal US and prenatal MRI and 71 (94.6%) fetuses diagnosis results were consistent between prenatal MRI and postnatal MRI. Functional MRI examination results showed that prenatal DWI demonstrated a significant difference (t-test: t value=3.82, P<0.05) on ADC values within ipsilateral whiter matter ROIs between younger fetuses (gestational age: 24 to 29 weeks, ADC: (1.83±0.108)×10-3mm2 /s) and older fetuses (gestational age: 30 to 39 weeks, ADC: (1.71±0.025)×10-3mm2 /s). Prenatal SWI examination was more precise and sensitive than general structural MRI on the detection of volume, range, location of haemorrhage. Conclusion It could be concluded that the combination functional MRI and optimized structural MRI have obvious advantages over prenatal US on clinical diagnosis of fetal brain abnormities. Prenatal MRI could provide more precise and reliable images which can help for the treatment of clinical abnormal and handicapped fetal.