The majority of case reports concerning intracerebral tumors are almost equally divided between teratomas and gliomas. We report a case of congenital intracranial teratoma with suggested management. An 18-year-old woman at 30 weeks' gestation in active labor because of severe fetal hydrocephalus and polyhydramnios was delivered by cesarean section. Spontaneous rupture of the neonatal skull led to delivery of a stillborn infant; a congenital teratoma was found. Although intracranial teratoma is a well-recognized entity in the differential diagnosis of pediatric brain tumors, massive congenital teratoma replacing cerebral hemispheres of a fetus has been seldom reported. Antenatal diagnosis of the neoplasm and abdominal delivery may not improve outcome.