Congenital cardiac defect is the major cause of mortality and morbidity in our country but maximum cases are undetected due to lack of skill, shortage of man power, modern equipment in peripheral hospitals. But simply observing murmur can give us the clue for underlying congenital heart diseases. The purpose of Study to evaluate the frequency and pattern of congenital heart disease in neonates (age ¿ 28 days) admitted in a tertiary care level hospital. During this study period total 4120 neonates were admitted in neonatal ward and only 52 cases were presented with cardiac murmur clinically. Incidence rate of murmur was 1.26%. Among 52 cases 40 cases were having pathological murmur and 12 cases were having innocent murmur. After doing echocardiogram 34 cases were showing structural cardiac defect out of 40 pathological murmur and 4 cases were showing structural cardiac defect out of 12 innocent murmur. Total cases of structural cardiac defect (congenital heart disease) were 38(34+4). If congenital heart disease is early detected and properly managed many valuable lives of neonates can be saved and their growth and development will be smooth.