Objectives Congenital heart defects (CHD) can be detected at ultrasound but are sometimes not diagnosed until birth, which can cause stress and heightened emotion within the family. Parents face challenges including dealing with surgical procedures for their child and integrating healthcare management into family life. The aim of this review was to understand parental coping with their child's CHD. Methods Six databases were systematically searched to identify qualitative studies relating to parental coping in the context of having a child with CHD and which met inclusion criteria. Studies were subject to quality appraisal using Walsh and Downe's checklist, and synthesised using Noblit and Hare's meta-ethnographic approach. Results The synthesis of 22 studies reporting on 704 parents' accounts showed that parent coping fell within four overarching themes: Emotional Responses, Support Systems, Parental Management and Avoidance. These four themes contained 13 subordinate themes. Conclusions Parental psychosocial coping varies over time from diagnosis, through surgery to childhood. Common themes were evident, but individuals employed their own styles and strategies based on prior experience, availability of social support, personal characteristics and beliefs. Parents tried to maintain a sense of normality, integrating CHD into their lives without it having a major impact except at times of transition and hospitalisation when they had to call on additional strategies or support to manage this stress. This review offers clear guidance to clinical services on how best to support parents and families. Keywords Family • Adjustment • Cope • Child • CHD Congenital Heart Disease (CHD) is one of the most common types of birth defects, affecting 8 per 1000 babies born globally (Bernier et al. 2010), and prevalence has increased over time (van der Linde et al. 2011). As there are many variations of CHD which sometimes occur in combination and with differing severities, prognosis and treatment may vary between individuals. NICE guidance (National Institute for Health and Care Excellence 2016) advises that "children, young people and their parents or carers may need support,

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