Abstract Background Patent Ductus Arteriosus (PDA) is one of the most common congenital heart diseases with a left to right shunt. PDA occurs in 5-10% of all congenital heart disease, excluding premature infants. It is more frequently occurs in women compared to men. Patients could be asymptomatic depending on the size of the PDA, systemic and pulmonary vascular resistance, and the size of the left-to-right shunt. Case Description We report a case of an 18-year-old girl presenting with PDA and left-to-right shunt. The patient underwent a PDA closure with a transthoracic echocardiography (TTE) guidance and used an occluder device. The procedure was performed without any complication, the patient was stable, and from the TTE control, we found no residual shunt and device in situ. Discussion Several adverse effects of PDA closure using fluoroscopy guidance had been highlighted due to its radiation exposure. The necessity of using a contrast agent is also confirmed to increase the patient risk. To this end, the closure of PDA using TTE guidance was developed to prevent the side effect of fluoroscopy for both doctors and patients. This method required a well-developed collaboration between the pediatric interventional cardiologist and echo-cardiologist. In conclusion, PDA Closure using a device and TTE guidance is as effective as fluoroscopy guidance. Closure of the PDA using TTE guidance may prevent patients and doctors from the adverse effects of radiation and minimize the risk of contrast agents.