For the last few decades, rhesus immunization resulted in high percentage of intrauterine fetal death, most commonly caused by incompatible blood transfusions. Discovery of the transfusion reaction and Rh factor, together with the development of successful prophylactic measures have reduced mortality to a minimum. Since mismatched blood transfusion is no longer seen, the state of Rh immunization is now primarily viewed as a characteristic state of heterospecific pregnancy, although it does not exclude other causes. Rh sensibilization depends on the interaction of several different immune and pregnancy factors. It accounts for about 10% of all pregnancies while the use of immunoprophylaxis has reduced the incidence of sensibilization to only 0.2%. Maternal immunization with fetal Rh antigens is clinically manifested by the development of fetal and neonatal hemolytic disease (HDFN) whose severity depends on the intensity of erythrocyte hemolysis. In practice, HDFN is divided into mild, moderate and severe disease. Diagnostic and therapeutic procedures are performed in the prenatal and postnatal period. Early diagnosis is marked with non-invasive methods for the purpose of detecting created antibodies titer and for choosing the therapy. Today, HDFN treatment is primarily focused on prevention. In terms of a progressed disease, phototherapy as well as intrauterine transfusion and exanguinotransfusion represent the basis of recovery from HDFN. As a result of recent studies, there is a tendency to abandon invasive therapy methods because of new insights.