Critical congenital heart disease [CCHD], a group of morphologically heterogeneous disorders, have one thing in common that they need early surgical or catheter intervention for survival. Neonates with CCHD may be diagnosed on the basis of physical examination findings, such as heart murmurs, tachypnoea or overt cyanosis. Apart from physical examination, pulse oximetry, chest radiography, electrocardiogram and echocardiography are useful tools in identifying many cases of serious congenital heart disease postnatally. In the current era, surgeries are done for repair or palliation for nearly all types of congenital heart malformations. Intervention needs to done in first weeks of life so as to optimize hemodynamics and prevent end-organ injury associated with delayed diagnosis.