Congenital heart disease and pediatric cardiology problems exist all over the world. The approach, however, including diagnosis and management varies considerably depending on manpower available, the clinical facility and the sociophilosophical climate prevailing in different parts of the world. In this article the priorities existing in the developed and developing countries concerning the approach to pediatric cardiology problems are discussed from the point of view of patient load, facilities available, teaching and research in this large field of highly specialized pediatric practice.