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Objective: The purpose of this study is to (1) examine ventricular width evolution between preoperative, early and late postoperative findings; (2) correlate the ventricular width and volume measured with a novel artificial intelligence (AI) based tool and (3) analyze the relation between the ventricular width and the ventricle delineation or hindbrain herniation. Methods: Retrospective review of in utero magnetic resonance imaging (MRI) scans performed in a tertiary center of fetuses undergoing surgery for open spinal dysraphism (OSD). Only fetuses with preoperative, early postoperative (<7 days) and late postoperative MRI acquired were included. Grade of hindbrain herniation and width and lining of the lateral ventricles were longitudinally analyzed. 3D superresolution reconstruction (SRR) volumes were created. Semi-automated segmentation of the ventricular system was performed. Results: Seventeen fetuses had all necessary images for this observational study. Four patterns of ventricular lining were noted: normal, undulated, irregular or nodular. The nodular pattern was evenly distributed between the different ventricular widths and was more often found later in pregnancy. A strong correlation between the ventricular volume and atrial width was found. All had hindbrain herniation preoperatively and demonstrated some reversal at the last MRI. Overall there was a significant increase in ventricular width between the preoperative and the late postoperative evaluation. Conclusion: Different patterns of ventricular lining were described. No relation between ventricular width and lining was found. Periventricular nodular heterotopia was most often found on the late-postoperative MRI.