Congenital heart disease are the most common form of congenital defects and are responsible for majority of deaths due to congenital diseases. Due to paucity of data from developing countries, it may be difficult to estimate the total burden, but the prevalence of CHD is not likely to be very different in these countries. The mortality and morbidity due to CHD is very high in India. CHD often remains undiagnosed or untreated in the vast majority of children due to lack of awareness amongst healthcare personnel. Factors responsible for current state are huge load of patients, lack of awareness about CHD, delayed referral, high cost of treatment, social reasons, inadequate investment in health, lack of policy and chaotic healthcare system. Various strategies for CHD are changes in healthcare delivery, Improve awareness about CHD, optimal utilization of resources, periodic auditing of services, reduce the burden of CHD, availability of trained staff and make treatment more affordable and accessible.