Open spina bifida (myelomeningocele) is a specific kind of neural tube defect (NTD) resulting from a trouble of closure of the caudal region of the neural tube early in embryogenesis. The diagnosis and management of open spina bifida has changed significantly over the past century. Significant advances in the prevention, diagnosis and treatment of open spina bifida have been made over the last years. The most significant strategy for the prevention of open spina bifida has been with folic acid supplementation. Although progress in the field of myelomeningocele diagnosis and treatment has revolutionised the medical treatment of open spina bifida, the postnatal treatment of myelomeningocele evolved significantly and is now complicated by issues surrounding prenatal diagnosis, including availability, economic feasibility, and selection for invasive fetal surgery and management of pregnancy.