The pathogenesis and in-utero classification of fetal lung lesions should be revisited. The proposed use of the term, lung dysplasia, according to the guidelines presented here, accompanied by evaluation of each lung component involved in the lesion, will facilitate classification of fetal lung anomalies. We believe that this simple descriptive approach based on available 2D sonography and Doppler mapping of vascular anomalies will further improve our understanding of the variability of fetal lung lesions. The applicability of this new classification system to clinical management is presented in the accompanying study.