Background  Congenital heart diseases (CHD) are the most common of all congenital malformations. Tetralogy of fallot (TOF) is the most common of the cyanotic defects. TOF consists of four major abnormalities occurring together; subpulmonaryinfundibular stenosis, ventricular septal defect, aortic overrides and right ventricular hypertrophy. This classification of Tetralogy of fallot according to the pulmonary trunk is the first study done in Sulaimani up to our knowledge. Objectives  To determine the morphological classification of tetralogy of fallot according to the pulmonary trunk in Sulaimani pediatrics teaching hospital – cardiology department. Patients and Methods This is a retrospective study conducted in Pediatric teaching hospital in Sulaimani for a total 308 cases from 1st Aug 2006 - 1st Aug 2012. The source of information was the medical and echocardiography records pediatric cardiology department from Sulaimani teaching hospital.  Results Among 308 cases, 109 cases were hypoplastic pulmonary branches, 185 cases were good pulmonary branches, 11 cases were unclear & 3 cases were absent pulmonary branches. Tetralogy of fallot are common in children age groups about 205 cases, 86 cases of infants, 14 cases of adults & 3 cases of neonates. Tetralogy of fallot had associated lesions like patent ductus atriosus (68) cases, ventricular septal defect (86) cases, atrial septal defect (26) cases, aortopulmonary collaterals (35) cases & aortic regurgitation (31) cases. 125 of 308 cases of Tetralogy of fallot were operated.  Conclusions Good pulmonary branches are common type of Tetralogy of fallot. Tetralogy of fallot is common in children age groups, slightly more common in males than in females. Additional ventricular septal defect & patent ductus atriosus are common associated lesions of Tetralogy of fallot.