We present a case of congenital listeriosis in a twin pregnancy. Presentation was prompted by decreased fetal movements and an ultrasound examination which demonstrated features similar to those observed in an adult with inflammatory conditions of the bowel, namely, small amounts of ascites, dilated loops of bowel and thickening of the bowel wall. Such ultrasound signs may be useful in consideration of the diagnosis of congenital infection and prompt diagnostic tests and appropriate interventions that assist in early therapy.