Background: Children with congenital heart disease (CHD) have increased prevalence of malnutrition for various reasons. This study aimed to identify prevalence and predictors of malnutrition in children with symptomatic CHD. Methods: This study included 110 children with symptomatic CHD (78 acyanotic and 32 cyanotic CHDs). Clinical Evaluation and Laboratory Assessment of Nutritional Status were documented. Anthropometric measurements were recorded and Z scores for weight for age (WAZ), weight for height (WHZ), and height for age (HAZ) have been calculated. Malnutrition was dened as weight, height, and weight/height Z score ≤–2. Results: The overall prevalence of malnutrition was 87.0 % in patients with CHD. Severe malnutrition was diagnosed in 49 % of cases. In both group of CHD patients, stunting and wasting was high. Malnutrition correlated with pulmonary hypertension, recurrent respiratory tract infections and feeding difculties but not statistically signicant levels. Conclusion: Malnutrition is a very common problem in children with symptomatic CHD and presence of feeding difculties, pulmonary hypertension, recurrent lower respiratory tract infections are additional risks for malnutrition.