Objective: The aim was to determine the effect of prenatal coaching mobile app with images of fetus produced by virtual reality (VR) to maternal-fetal attachment and depressive mood. Methods: This 2-arm parallel randomized controlled trial involved 88 pregnant women and eight patients withdrew prior to intervention. Eligible women who provided written informed consent were randomly assigned to either the mobile app only group (n=44) or the app with VR group (n=44). The prenatal coaching mobile app consisted of recommended health behavior for pregnant women according to the gestational age, feedback for inserted data of maternal weight, blood pressure, and glucose, and the service for private diary with fetal ultrasound images. Both groups received the same app, but the VR group underwent the experience of fetal image produced by VR and those images were stored in the app. All participants performed questionnaires to assess maternal-fetal attachment, depressive mood, and other basic medical information and those questionnaires were repeated after the interventions. Results: Eight patients (four for each group) lost to follow-up and the basic demographic data were comparable between two groups. Most of the assessments showed comparable results between two groups, however the mean score to assess interaction with the fetus was significantly higher for the VR group than the control group (0.4 vs. 0.1, p=0.004). The proportion of increased score for this category after the intervention in the VR group was significantly higher than the control group (43% vs. 13%, p=0.005). The feedback questionnaire demonstrated the scores assessing how much the participants understand fetal appearance were all increased after the intervention in the VR group. Conclusion: The use of mobile app with images of fetus produced by VR significantly increased maternal interaction with fetus in the assessment of maternal-fetal attachment.