Ventricular septal defects are the most common congenital cardiac anomalies. Indication for surgery is based upon the shunting ratio, pulmonary vascular resistance (PVR) and pulmonary artery pressure (PAP). Surgical intervention is dependent on the VSD localization on the interventricular septum, presence of associated cardiac anomalies and either through the right atrium, right ventricle, left ventricle pulmonary or via a transaortic approach, the defect can be repaired. Transatrial and transventricular approaches are the most common techniques. The advantages and disadvantages of both techniques are still being debated. In our present study, we found that preoperative PAP and PVR arc more important in the patient prognosis rather than the route of surgical intervention.