The introduction of ultrasound in the detection of pregnancy brought a revolution in the analysis of possible pathology, already in the early stage of the development of the embryo and fetus. Congenital uterine anomalies have a negative impact on the reproductive potential of women and also increase fetal and maternal morbidity and even mortality, especially in the fetus during pregnancy and delivery. The association of myoma and pregnancy is becoming more frequent due to the increasing age of the first pregnancy. It may affect the outcome of fertility, pregnancy, labor, and peripartum course. The isthmocele is a myometrial defect resembling a pouch on the anterior wall of the uterine isthmus over a previous cesarean scar. The increase in the incidence of isthmocele is the result of an increase in the percentage of births completed by cesarean section, which has been a trend over the last decades. Due to the increased use of high-resolution ultrasound, around 80% of ectopic pregnancies are diagnosed before rupture, and >50% are diagnosed in asymptomatic patients. Two-dimensional (2D) and three-dimensional (3D) ultrasound identification of an adnexal mass, empty uterine cavity, and positive pregnancy test are gold standards for diagnosis. The advancement of ultrasound with the introduction of new techniques such as 3D ultrasound, 3D color Doppler, and power color Doppler brings a new quality to detecting potential pathology already in the early stages of pregnancy.