Background: Congenital heart disease (CHD) is a range of structural anomalies of the heart, which affect around 1% of births. Individuals with CHD often require complex life‐saving surgeries in infancy and lifetime follow‐up. Very few studies have been focused on the relationship between the weight at repair and early and late outcomes. Most surgeons would prefer to correct the VSD before 6 months of age, however medical therapy is generally used in neonates, low weight young infants, and low birth-weight babies primarily because of technical concerns about the fragility of the common atrioventricular valve (CAVV) tissue. Aim of the Work: to evaluate the impact of weight less than 5 kg at operation on mortality and morbidity in patients with ventricular septal defect undergoing surgical closure. We conducted a systematic review and meta-analysis of 5 studies including neonates with weight at surgery less than 5 kilograms. Patients and Methods: Application of inclusion and exclusion criteria to study abstracts yielded 5 articles. A total of 20 studies were identified from the database search. After review, a total of 5 studies were selected. Results: In the current study, we assessed the mortality rate among the five studies. The mortality rate among the five studies ranging from 0% to 4.16% Residual VSD ranged from 0% to 19.42%. The five studies ranged in publication from 2004 to 2021. There were three retrospective studies included in our systematic review and two prospective studies. There were 2933 neonates included in this study. The sample size ranged from 48 to 2473. Among them there were 1259 males and 1674 females. Conclusion: In conclusion, despite the advancements in surgical devices and techniques, lower body weight was significantly associated with increased risks of the composite end point within 30 days after surgery. The risks of mortality from 0% to 4.16% Residual VSD ranged from 0% to 19.42% which could be a valid threshold with acceptable risk. These findings are useful for patient counseling and might aid in facilitating understanding of the risk of surgery.