Abstract: This revue presents the latest data on fetal pain and on safe and effective techniques for providing direct fetal anesthesia or analgesia in the context of therapeutic procedures or abortion. Pain is a subjective experience occurring in response to impending or actual tissue damage. Pain perception requires conscious recognition or awareness of a noxious stimulus. Neither withdrawal reflexes nor hormonal stress responses to invasive procedures prove the existence of fetal pain, because they can be elicited by nonpainful stimuli and occur without conscious cortical processing. Current theories of pain consider an intact cortical system to be both necessary and sufficient for pain experience. Good evidence exists that the biological system necessary for pain is intact and functional from around 26 weeks’ gestation. Pain invasive fetal procedures clearly elicit a stress response, and attenuation of this response may be beneficial. Keywords: fetal pain, fetal psychology, fetal anesthesia