Fetal cardiac myxomas are very rare. To date there has been no representative description of fetal cardiac myxomas. The aim of this study is to highlight the clinical features, possible outcomes and the disparities from the adult cardiac myxomas and other fetal cardiac tumors. A comprehensive literature review yielded 27 reports including 32 cases of fetal cardiac myxomas. Apart from the same pedunculated and solitary nature and echogenic appearance, fetal cardiac myxomas differ from those in adults in many aspects, including tumor location, clinical manifestation and malignant potential. Fetal cardiac myxomas are the most common in the left ventricle and the least common in the left atrium. Tumor size and tumor site could be predictive risk factors of adverse cardiac events of fetuses. Their clinical courses are often benign with fewer cases of adverse cardiac events. Prenatal echocardiography is a reliable diagnostic technique, which can detect cardiac myxomas at as early as 18 weeks gestation. Differential diagnosis should be made from other types of fetal cardiac tumors. Postnatal cardiac myxoma resection may provide a good prognosis.