Background: Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles. While often referred to simply as "heart failure," CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently. An evaluation of screening for CHDs is very important, echocardiography is a non-invasive technique and Modern two-dimensional echocardiographic strategies offer a comprehensive way for evaluating virtually all types of CHD observed in both adults and children. Objective: The aim of this study is to find out the most common clinical presentation of congenital heart defects in children from 3 months to 16 years of age referred to echocardiography and confirm the presence of disease on echocardiography in Children Hospital Lahore. Methods: This is a descriptive and prospective Hospital-based study conducted in the pediatric cardiology unit outpatient department of CHILDREN HOSPITAL. This study included all the patients, irrespective of age, having confirmed the diagnosis of CHD on the basis of echocardiographic report. Results: In my study, 288 patients of clinically Diagnosed CHD referred to echocardiography were studied. Congenital heart defects were diagnosed more commonly between 3 months to 5 Years than other age groups. The reason for the higher incidence in the age group of 3 months to 5 years maybe that CHD becomes symptomatic at that age group. The commonest congenital heart defects with a single lesion in our study were Ventricular septal defect followed by Atrial septal defect, Tetralogy of Fallot, Patent ductus arteriosus Conclusions: We observed that Symptomatic patients mostly present in 3 months -5 years of age. At 0.16-5 year of age child presented with sweating, respiratory distress, syncope and tachypnea. While from 5-16 years, commonest symptoms were murmur, chest pain, respiratory distress, tachypnea. The most symptomatic lesion Congenital heart defects were Ventricle septal defect and Teratology of fallot Ventricle septal defect, Atrial septal defect Pulmonary stenosis. Transthoracic echocardiography is an important tool for confirmation of clinical presentations of CHD at different age group.