Background: Several more access routes of have been described. Umbilical artery catheters (UACs), and umbilical vein catheters (UVCs). CVCs can be placed in numerous sites, including the internal jugular vein (IJV), the subclavian vein, the femoral vein, peripheral veins leading to central access, and other surgical access sites. Objective: To compare central venous cut-down catheterization versus percutaneous central venous catheterization in neonates and infants regarding technical feasibility, indications, operative time and complications. Patients and Methods: This is a prospective study on two different methods for central line insertion in neonates and infants. This study was done at Al-Azhar University Hospitals, in Pediatric Surgery Department, Neonatal Intensive Care Unit and Pediatric Intensive Care Unit. One hundred patients who required central venous catheterization were included in this study, during period between December 2018 and October 2019. Results: The present study reported that the ultrasound guided CVC was more useful in placement of CVC in infants and neonates, and decreasing complications. The ultrasound technique not only clarified the relative position of the vein and its surrounding structures but also helped in identifying the course of the central vein and its caliber and provide confidence to the operator Conclusion: The present study reported that the ultrasound guided CVC was more useful in placement of CVC in infants and neonates, and decreasing complications. Cost is one of the limiting factors in the availability of ultrasound device in many clinical applications.