Duct dependant circulations needs high degree of suspicion, early stabilisation with prostaglandin and early diagnosis and treatment. Early PGE1 infusion is an economically viable option in the management of these sick neonates. Majority of them present in the first week of life and do well with prompt and proper approach to the problem. Prostaglandin plays important role as a palliation before undergoing any palliative or definitive surgery. Titration with low effective dose regimen of prostaglandin definitely helps to maintain adequate response without increased complications. Mortality remains high in duct dependent circulation even with use of prostaglandins and interventions.

Keywords: Duct Dependent Circulation; Congenital Heart Disease; Prostaglandins.