Background: Congenital heart disease (CHD) carries a high rate of mortality and morbidity in the pediatric population. The gold standard technique for diagnosing CHD is echocardiographic examination. Objectives: To assess the CHD pattern among children referred for echocardiography in Ramadi city, west of Iraq and to determine the correlation of various types of CHD with age and gender. Materials and methods: The study conducted at Maternity and Children Teaching Hospital in Ramadi. All patients who evaluated by echocardiography from June 2013 to March 2015 were included in this study. All children were evaluated by transthoracic echocardiography using M-mode by a pediatrician trained in pediatric ECHO. The pattern of CHD was studied, taking into consideration age and gender distribution. Results: The age range of our 262 patients was 1 day to 14 years (mean 16.6±30.3 months) and the male to female ratio 1.04:1. Acyanotic CHD comprises 87% of the cases. There were 188 (71.76%) patients diagnosed in infancy. Ventricular septal defects (29.39%) were the commonest type, atrial septal defects (16.03%) were the second, and the least Ebstein anomaly (0.38%). The commonest cyanotic cardiac defect was Fallot Tetralogy. There was a male predominance in ventricular septal defects, Tetralogy of Fallot, aortic stenosis, coarctation of the aorta, and D-transposition of the great arteries. While, female predominance observed in atrioventricular canal defect, atrial septal defects, patent ductus arteriosus, and pulmonary stenosis. Conclusion: CHD mostly diagnosed in the infants. Acyanotic CHD was the commonest defect. Ventricular septal defects were the commonest acyanotic defect. While Fallot Tetralogy was the commonest cyanotic CHD. Sex distribution was comparable to that observed in the studies from other parts of the world. [ABSTRACT FROM AUTHOR]