A 23-year-old pregnant woman， gravida 1， para 0. Single fetus at 34 weeks of gestation，a high-risk ultrasound consultation revealed a cystic-solid mass was found in the lower part of the tongue body， multiple segregations were seen inside， and the mass moved in synchronization with the swallowing movement of the fetal tongue， and was poorly demarcated from the body of the tongue， streaks of colorful blood were seen around the periphery， and the tip of the tongue was located outside of the oral cavity， which was considered to be hemangioma or lymphangioma of the tongue. MRI at 36 weeks of gestation showed a T2WI high-signal mass in the lower part of the fetal tongue， which was considered to be hemangioma or teratoma. The neonate was referred to the Children’s Hospital， Fudan University 3 days after birth for cystic fluid extraction and sclerotherapy， which confirmed a lingual lymphangioma. This article focuses on the imaging manifestations and neonatal treatment of fetal tongue lymphangiomas in order to increase clinicians’ understanding of lingual lymphangiomas.