The clinical presentation of congenital heart disease varies according to the type and severity of the defect. Aim of the study: The aim of this study is to observe the clinical presentation and complications of different congenital heart disease. Material & Methods: It was a hospital based Cross-sectional study carried out prospectively in the department of pediatrics of Rajshahi medical college & hospital in from July 2011 to December 2011. The study population was all the children up to 12 years of age admitted in three pediatric units of this hospital during the study period. History included the presenting complaints of the patient's e.g. breathlessness, cough, palpitation, undue fatigability, bluish coloration or lips, tongue and extremities, history suggestive of cyanotic spell, feeding problem, poor weight gain, recurrent chest infection etc. Onset of symptoms and duration were noted. Chest X-ray reports were done by radiologists, ECG reports and echocardiography were done by cardiologists of RMCH. Among the 147 clinically suspected cases congenital heart disease was confirmed in 110 cases by echocardiography. Results: Total 110 patients with different types of congenital heart disease were included in this study. Male: female ratio were 2:1. the commonest lesion was VSD present in 39.1 (%) patients and single ventricle with single A-V canal defect in 0.9 (%). Rest patients had multiple lesions. The commonest presentation was recurrent chest infection which present in 69.1 (%) of patients. The commonest physical finding was anemia, present in 72.7 (%) of patients. Among 110 patients, 101 presented with different complications. Heart failure was present in total 15 cases, among them 40 (%) of VSD, 33.3 (%) of PDA and 26.7 (%) of multiple lesions patients presented with heart failure. Growth failure was observed in total 23 cases, among them 13 (%) of VSD, 21.7 (%) of ASD, 43.5 (%) of TOF, 8.7 (%) of PDA and 13.1 (%) of other patients presented with growth failure. Pneumonia was noted in 54.3 (%) of VSD, 22.9 (%) of ASD, 17.1 (%) of PDA and 5.7 (%) of other patients. Recurrent chest infection was noted in 70 (%) of VSD and 30 (%) of PDA patients. Pneumonia with heart failure was noted in 54.3 (%) of VSD, 22.9 (%) of ASD, 17.1 (%) of PDA and 5.7 (%) of other patients. Cerebral abscess occurred only in TOF cases. Conclusion: Fast breathing, chest indrawing, cough, poor weight gain, feeding problems, anemia, cyanosis, clubbing, easy fatigability, recurrent chest infection and murmur detected in routine cardiac examination