The fetal auditory system becomes functional during mid-gestation or possibly even earlier. Existing data show that fetuses can respond to maternal voice and different types of music, both vocal and instrumental. The ability to receive and transmit sound waves, and then recognize and retain some memory of these auditory stimuli could possibly be one of the most important developmental sensory milestones that we need to learn about. Unfortunately, we still have limited evidence for the precise role and timing of prenatal sound simulation. There is a need for methodologically strong, randomized controlled trials with rigorously designed interventions and standardized reporting measures. We may need to compare different durations and types of musical (sound) intervention. At a minimum, these interventions can improve maternal–fetal bonding and family-centered outcomes. Any evidence of neurodevelopmental gains would be an important scientific/medical advancement. In certain conditions such as neonatal abstinence syndrome, emerging evidence suggests that early, in utero intervention with music therapy can be helpful; these findings bring hope for new therapeutic tools to enhance the neurological development of at-risk fetuses. Considering that prenatal music exposure might have positive effects on the fetus and newborn infant, we need carefully conducted studies of intrauterine neurosensory organization with long-term follow-up.