Objective: To evaluate the pattern of Congenital heart disease (CHD) in Al-Mugref Teaching Hospital in the North Eastern part of Libya. Patients and Methods: This is a prospective descriptive study involved pediatric patients aged from day 1 until age of 15 years who were referred to the Cardiology department at Almugref Teaching Hospital for suspected CHD. Data were collected over a period of one year and all the recruited patients were subjected to a full cardiovascular system (CVS) examination and 2D Echocardiography (ECHO). Results and Conclusions: Out of the 719 total referred cases, 332 (46.1%) were confirmed having underlying CHD with predominant a cyanotic type 307 (92.5%). In terms of gender predominance, male to female ratio was 1.1: 1(176 vs. 156). Frequency of CHD in order frequency was as follow: Atrial septal defect (ASD) 134; 40.4%, Ventricular septal defect ( VSD) 102; 30.8%, Patent ductus arteriosus (PDA) 31; 9.3%, Pulmonary stenosis (PS)15; 4.5%, Atrioventricular (AV) canal defects 12; 3.6%, Aortic stenosis (AS)11; 3.3%, Tetraology of fallot (TOF) 9; 2.7%, Transposition of great arteries (TGA) 4; 1.2%, complex CHD (4; 1.2%), Rhabdomyoma (3;0.9%),  total anomalous pulmonary venous drainage ( 3; 0.9%), Truncus arteriosus (TA) 2; 0.6%, Pulmonary atresia (PA)1; 0.3%, Co-arctation of aorta (COA) 1; 0.3%. In terms of the outcome, majority of the patients in a cyanotic group were advised for scheduled follow-ups (240; 78.18%), and almost a quarter had their heart defects being closed spontaneously in the initial visits (53; 17.26%). Further, eleven patients have undergone a surgical closure (3.58%) and three patients died early (0.9%). In contrast, almost a third of the cyanotic group died shortly after the diagnosis was made (8; 32%), and seven patients were successfully operated (28%); whereas ten cases offered a close monitoring with frequent follow ups (40%).