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AbstractCritical congenital heart diseases (CCHD) are important causes of mortality and morbidity in the newborn period.Even after diagnosis, their management could be seriously compromised by the unplanned delivery in hospitals with
limited expertise and resources. The newborn may spend days or week before transport putting a signifcant bur-den on the neonatal team to manage such challenging diseases. In this review, the management principles of each
individual pathology are discussed in the setting before transport to cardiac centers. Understanding these principles
will help the treating teams evaluate and manage those complex conditions. The review avoids the advanced discus-sion on the management of CCHDs not applicable to the pre-transport setup. It highlights the critical elements in the
maintenance of normal hemodynamics specifc to each pathology and their variation.Keywords: Critical congenital heart, Cyanosis, Newborns, Congenital, Hemodynamics, Critical