In double outlet right ventricle (DORV) both the great arteries arise wholly or in large part from right ventricle (RV). The relation of great arteries and location of VSD form the basis of classification. The presence and degree of ventricular out flow obstruction affects the clinical presentation and the management. In the commonest type both the vessels go side by side with aorta to the right of PA and a sub-aortic VSD. In absence of PS it mimics nonrestrictive VSD with left to right shunt. When pulmonary vascular disease develops it cannot be differentiated from Eisenmenger complex. With severe RVOT obstruction it presents like TOF. The presence of double coni, more than 50% aortic override and aorto-mitral discontinuity distinctly favor DORV. Both these conditions can be differentiated by ECG, echocardiography and cineangiography. Taussig-Bing anomaly is a rare form with large sub-pulmonic VSD with no PS and presents like complete transposition of great arteries. Complexity of anatomy and the state of pulmonary vasculature decides the management of DORV in general. Compared to TOF the repair of DORV-VSD-PS is more complex because of the need to create a tunnel from VSD to aorta.