Objective: To analyze the etiology and outcome of non-immune hydrops fetalis (NIHF) in Southern China.Methods: Data were reviewed for pregnancies diagnosed with NIHF at different gestational ages from 1 January 2007 to 31 December 2014.Demographic data, prenatal interventions, clinical and laboratory findings, outcomes, and the results of post mortem examinations were analyzed.Results: During the period of study, a total of 482 cases were documented.The causes of fetal hydrops were identified in 86.9 %.Hb Bart's disease dominated as the main cause of NIHF (61.8%), followed by abnormal chromosomes (13.5%) and cardiovascular defects (8.1%).The underlying etiology remained unknown in 63 cases (12.5%).Four hundred and four cases with hydrops presented after 20 weeks' gestation, including 279 cases of Hb Bart's disease, 35 cases of cardiovascular defect, and 7 cases of infection.Abnormal chromosomes with hydrops mainly presented between 15-19 weeks' gestation.Termination of pregnancy was performed in 461 cases.Conclusions: The causes of hydrops are in relation to gestational age.Hb Bart's disease is the most common cause of NIHF in Southern China.An effective prenatal screening program for thalassemia should be established in this region.