Considering a birth prevalence of congenital heart disease as 9/1000, the estimated number of children born with congenital heart disease in India is more than 200,000 per year. Of these, about one-fifth are likely to have serious defect, requiring an intervention in the first year of life. Currently advanced cardiac care is available to only a minority of such children. A number of cardiac centers have been developed over the last 10 years. However, most are in the private sector, and are not geographically well-distributed. Challenges to pediatric cardiac care include financial constraints, health-seeking behavior of community, and lack of awareness. Government of India is taking a number of steps for improving health of children through its various program and schemes that are likely to benefit children with congenital heart disease, especially those who are vulnerable and marginalized.