The true umbilical cord knot has an incidence at birth of up to 1.22 %. During prenatal ultrasoundscanning, a cloverleaf pattern, the hanging rope sign, fixed loop, cord loop or cyclone sign may be observed. A clinical case of prenatal diagnosis of true cord knot with good perinatal outcome is reported. We present the case of a 28-year-old female patient at 33.1 weeks of gestation. The ultrasoundscan showed a cloverleaf pattern, a hanging rope sign and a fixed loop in the umbilical cord,confirming the suspicion of a true cord knot, as shown by color Doppler and 3D imaging. Weeklyfollow-up with Doppler ultrasound and non-stress testing was conducted. A cesarean section wasscheduled at 37 weeks, resulting in a newborn weighing 2,870 grams and measuring 47 cm, withno signs of asphyxiation. The diagnosis was confirmed at birth. 3D and 4D ultrasound imaging has proven to be reliable a method ...