Fetal tachyarrhythmias may occur in 0.4-0.6% of pregnancies. Supraventricular tachycardia (SVT) is the most frequently reported fetal tachyarrhythmia. Fetal SVT is a rhythm disturbance characterized by 1:1 atrioventricular conduction at a rate between 220 and 300 beats per minute. Digoxin is the most common first-line antiarrhythmic agent for fetal SVT, but there is no consensus on the most effective second-line therapeutic agent. Herein, we report a case of SVT at her 23rd week of gestation in whom digoxin and sotalol combination therapy failed. Management guidelines in the literature were also reviewed.