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Cardiac lesions are the most common congenital deformities. Pulse oximeter is a valuable tool for early detection of Congenital Heart Diseases in the rural areas, which do not have a well-equipped cardiology set up. The aim of the present study was to study the efficaciousness of pulse oximeter along with the clinical parameters in detecting congenital heart diseases in the newborns with echocardiography as the investigative modality. A prospective observational study was conducted in the Department of Pediatrics at Kamla Nehru State Hospital for Mother and Child (KNSHM & C), newborn unit and Department of Cardiology, Indira Gandhi Medical College, Shimla, which is a tertiary care hospital. The study involved 3464 consecutive newborns with gestation more than 35 weeks who underwent pulse oximetry and physical examination from 0-48 hours of life. Pulse oximetry examination was performed on the left foot of newborns for at least 2 minutes in a stable position with Comet BPL and T medical’s new dual parameter colour TFT portable monitor. The results were analysed using SPSS software, and the probability value of less than 0.05 was considered significant. The study enrolled a total of 3580 newborns. A total of 3464 (96.76%) infants were enrolled in the study and the rest 116 (3.24%) were excluded from the population of the study as they did not meet the inclusion criteria. 45 newborns with SPO2< 95%, 9 (0.26%) had cyanosis. Amongst the 3419 patients with SPO2> 95%, cyanosis was absent (100%). There was a significant difference in cyanosis amongst both the groups. There were 6 …