This chapter aims to provide a simple and pragmatic diagnostic approach to a baby with suspected congenital heart disease as well as current prognostic implications for the short term. The second part of the chapter discusses guidelines for initial stabilization and transport of a newborn with suspected congenital heart disease, since such a baby would need care in a specialized unit for optimal outcome. The last two decades have witnessed tremendous advances in refinements of surgical and catheter interventions in newborns with congenital heart defects with steadily improving outcomes (91-95% discharge survivals–survival after operation for dtransposition of great arteries being 95-100% in the current era). During the last decade there has been a meteoric growth in neonatal cardiac services in our country too with excellent and comparable outcomes for catheter interventions and surgery despite the problems of late presentation, presentation in circulatory collapse, pre-existing sepsis and associated growth reduction.