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Objective: To determine the frequency of congenital cardiac lesions in pregnant women reporting for fetal echocardiogram and correlate with obstetrical risk factors. Study Design: Descriptive cross-sectional study. Place and Duration of Study: To be conducted at pediatric cardiology and obstetrical unit of AFIC/NIHD and CMH Rawalpindi, from Jan 2009 to Jan 2020. Methodology: Pregnant women referred for fetal echocardiogram from 19-49 years of age were enrolled. Echo was done between 20 to 36 weeks gestation. Primary outcome was the nature of cardiac lesion and gestation at diagnosis. Neonatal scan was done at follow up to confirm cardiac diagnosis. Secondary outcome was obstetrical risk factors which were the reason for referral. This included age consanguinity, family history, previous history of intrauterine death or early neonatal death, maternal and paternal diseases. Data was collected and analyzed n frequencies and percentage. Chi-square was applied for association between variable and p-valve 0.05 was considered significant. Results: A total of n=967 pregnant women referred to outpatient department for fetal echocardiogram. Congenital cardiac lesion were detected in n=83 patients. Majority of patients had CAVSD (1.2%) CCAVB (1.2%) followed by ASD (1.1%) VSD (0.9%) Abnormal heart rate (0.8%) Single ventricle (0.3%). Most significant maternal age group was between 21 to 30 and 30-40 years (43.7 and 46.2%). Only 3% below 20 years and 6.7% above 40 years of age. Most important maternal risk factor was previous off spring 0.5% past family history 0.3% and abnormal obstetrical ultrasound 0.3% Followed by maternal diabetes 0.1% and maternal hypertension 0.1%. The yield of detection of congenital cardiac lesions was 8.3%. Conclusions: Congenital cardiac diseases are the second most common congenital anomaly and huge burden n pediatric population. Timely diagnosis and referral can be lifesaving.