Abstract: Objective: Although there are plethora of clinical studies relating to birth prevalence of Congenital Heart Diseases an attempt is madeto depict the pattern of congenital heart diseases with associated maternal and neonatal risk factors and their burden in NICU of Tertiary care hospital in Eastern India. Methodology: To depict the pattern of congenital heart diseases with associated maternal and neonatal risk factors and their burden in a Tertiary care hospital NICU. For this purpose the required cross sectional data has been gathered from NICU of tertiary care hospital,of Eastern India,Odisha,between May 2018-April 2020.Study population include newborns admitted in NICU during the study period. 2D ECHO was done in those newborns who had respiratory distress, tachycardia,murmur on clinical examination,wide pulse pressure, cyanosis, syndromicbabies.Cases which were diagnosed to have Congenital heart defect with the help of 2D ECHO remained comprised in the research. The parameters that were considered in the study include: Range of Congenital Heart Diseases in NICU, Clinical profile and presentation(tachypnea,tachycardia, murmur on examination, cyanosis,wide pulse pressure) Maternal risk factors(Maternal age,Hypothyroidism, GDM,Bad obstetric history) and Fetal risk factors(prematurity,low birth weight,gender,other associated abonormalities) were studied. Results: Total number of NICU admission during study period were 1720,of which 66 were diagnosed to have congenital heart diseases by 2D ECHO. It was found in the study that Acyanotic Congenital Heart Disease was more prevalent than Cyanotic Congenital Heart Disease. and TAPVC was most common acyanotic heart diseases.It has also been noted that number of male babies affected were more than females(M:F=2.6:1), Birth weight less than 2500gm was observed in most of the cases.Number of term and preterm cases were nearly equal.Most common clinical presentation was respiratory distress,followed by tachycardia.Mean Maternal age at conception obtained in the study was 24.05years.6 of the cases had history of Maternal Hypothyroidism, 6 were IDM(5 GDM,1 Type 2 DM), 4 had bad obstetric history. 1 had Cleft Lip and Cleft Palate,2 were Syndromicbabies(Downs),2 had TEF,GI 4 cases were associated with GI Anomalies and 2 with Renal anomalies. Conclusion:Encountering Congenital heart disease in NICU is not uncommon, hence all newborns admitted in NICU should undergo screening 2D ECHO,which might aid in early diagnosis and formulate necessary management,thus improving the outcome.Awareness about Fetal Echocardiography should be created in our country and should be employed in high risk maternal cases,so that complex congenital heart diseases can be diagnosed antenatally which will aid in planning delivery in a setup which has interventional facilities,thus improving the outcome and survival of the newborn