Advances in fetal monitoring and open fetal surgery for life-threatening congenital diseases have provided us with the unique opportunity to examine fetal surgical wound healing. Fetal wounds heal rapidly and without scarring. The exact mechanisms of fetal scarless healing remain unknown. This article illustrates the most current understanding of the fetal wound healing process by examining the intrinsic properties of fetal skin, fetal fibroblasts, wound matrix, fetal environment, and various cytokines. In fetal wound, transforming growth factor-beta and hyaluronic acid-rich wound matrix play pivoting roles in scarless repair. Different experimental strategies to manipulate the healing of adult wounds will be presented. These therapeutic measures are based on the scarless fetal wound repair model. We will also briefly comment on the current status of fetal surgery.