Residual Ventricular septal defect after surgical repair for Tetralogy of fallot(TOF) can occasionally be heamodynamically important requiring re-intervention.Closed observation and followup make this defect heamodynamically insignificant, required no medication and no endocarditis.We describe one patient having residual defect after surgical repair of TOF. Keywords TOF; Residual VSD DOI: http://dx.doi.org/10.3329/cardio.v3i2.9196 Cardiovasc. J. 2011; 3(2): 233-234