Back ground: Congenital heart disease (CHDs) is the most common birth anomaly worldwide and it has a significantly
increasing prevalence rate. Traditional evaluation for assessment depends on echocardiography (ECHO) and conventional
angiography. Recent technological advances in computed tomography (CT), is increasingly used for noninvasive evaluation and proper diagnosis. Aim of work: To examine the validity of administering low exposure dose by MDCT with the aid of ECG gating technique and post processing 3D reconstruction in diagnosis and follow up of congenital heart disease in pediatrics. Patients & methods: This study was performed on 40 patients with age ranged from 3 days to 16 year old with suspicious or clinically /echocardiographically known to have congenital heart disease. The study was performed with MDCT machines (64 and 80 slices spiral CT)with ECG gating technique. The radiation dose was kept to minimum by reducing the kilo voltage to 80 kvp . All patients underwent Nonionic contrast agent injection. Results: we found that there is overall no significant difference between the low Kvp ECG gated MDCT and high Kvp MDCT in detecting congenital cardiac anomalies moreover , in our study we detected some anomalies which were not reported by high Kvp < br />protocol in other studies. Conclusion: low Kvp ECG gated MDCT is superior to conventional method of CT scanning in assessment of congenital heart anomalies as it reaches to the same diagnosis with less radiation dose and hazards