Congenital heart disease is one of the major causes of mortality and morbidity in the pediatric population of both the developing and developed countries. Variability in incidence and prevalence of CHD from various countries of Indian subcontinent and rest of the world could be because of genetic, cultural, and environmental factors. Objective: To find the prevalence and pattern of CHD in a tertiary care hospital in Kashmir (J&K). Materials and Methods: All children admitted at territory care hospital with age 0-15 years were screened for congenital heart disease. The study was conducted for period of one year to ascertain the prevalence and spectrum of CHDs. Results: A total of 232 patients out of 23000, were found having CHDs measuring a prevalence of 10.5/1000. About 170 (73%) were the acyanotics, and 62 (27%) were cyanotic heart patients. Among the acyanotic heart diseases ventricular septal defect was the most frequent lesion seen in 54 (23%), followed by patent ductus arteriosus in 50 (22%) children. Among the cyanotic heart diseases tetralogy of Fallot was the most frequent cyanotic heart disease seen in 15 (6.4%) patients. Conclusion: We observed high hospital based prevalence of CHD in our population. The pattern and spectrum of CHD is comparable to national and international data. A national registry for CHD is the need of the hour.