Introduction Echogenic lung lesions (ELL) are a heterogeneous group of lung abnormalities that display a variety of features and are inherently difficult to diagnose and characterise antenatally. Included in this group are congenital cystic adenomatoid malformations (CCAM), pulmonary sequestration, broncho-pulmonary atresia, and congenital emphysema.

Objectives To investigate the changing incidence of echogenic lung lesions detected both antenatally and postnatally.

Methods A retrospective review of cases identified from the Fetal Medicine database and the Wessex Antenatally Detected Anomalies (WANDA) congenital anomalies register from 1994 to 2011.

Results We identified a total of 111 cases of ELL in 492,559 births during the stated period. All but six cases were identified on antenatal ultrasound.

In 1994, the total incidence of ELL was 0.37 per 10 000 births. By 2011 this had risen to 5.39 per 10 000 births, with a progressive incline during the intervening years.

Conclusion We found a nearly 15-fold increase in the incidence of ELL found antenatally in the Wessex region between 1994 and 2011. It is unclear whether this is due to a true rise in the incidence of this abnormality, or due to increased antenatal recognition as a result of improved ultrasound resolution and operator experience.