Due to the lethal nature of Hb Bart’s hydrops foetalis and its adverse effects on foetal and maternal health, genetic counselling and prenatal screening for couples at risk of having a foetus with Hb Bart’s hydrops foetalis should be offered to all couples. Detailed and non-directive counselling should be provided and management options should be discussed. In cases where parents wish to continue with the pregnancy, management should be provided at centres with experience in caring for foetuses with Hb Bart’s hydrops foetalis. Early ultrasounds to detect hydrops and associated congenital abnormalities should be performed. Early intrauterine transfusion and close follow-up on foetal and maternal status should be offered. The care team should be coordinated between obstetrics and neonatology for postnatal intensive care and haematology for long-term management.