Abstract: Congenital cardiac diseases are recognized as a major predisposing substrate for infective endocarditis(IE) worldwide, due to wide spread epidemiological changes observed in last decades in children with infective endocarditis(IE), resulting from increased survival rate of children with congenital heart disease (CHD) due to advancement in surgical interventions together with decreasing incidences of Rheumatic valvular heart disease (RHD) in the pediatric age due to involvement of new modified antibiotics policy, surgical management and enhancement of public awareness. Around 70% of cases of infective endocarditis (IE) occur in children with congenital heart disease (CHD), in whom majority of cases are ventricular septal defect (VSD). Here endothelial damage followed by presence of bacteremia are two important determining factors for Infective endocarditis (IE). These children had some form of underlying hemodynamic instability, such as a pressure gradient or turbulent flow between two cardiac chambers or the great vessels that create shear forces of abnormal high-velocity jet.