Objective; Since 1992 Paediatric Cardiac Surgery (PCS) in Libya was performed in a sporadic manner mainly by visiting surgeons from Europe and was confined to older children. Since 1992, a program was started to establish the specialty of Paediatric Cardiac Surgery in Libya.

Method; A total of 1302 children, age 3 days to 16 years old, were operated upon over a two 6-year period. The first 6-year period was between 1992-1998 and the second period between 2002 - 2008.

Results: During the first period(92-98), a total of 505 operations were performed; 354 (70%) were closed heart operations while 154 (30%) were open heart operations. The majority 318 (63%) were children older than 1 year and 190 (37%) were infants. One neonate with Transposition of Great Arteries (TGA) underwent a successful Arterial Switch Operation (ASO) in 1996.
This trend changed during the second period (02-08). The total number of operations increased to 800 cases (60% increase) with an increase in number of open heart procedures to 405 (51%) with 395 (49%) being closed heart cases. The number and percentage of infants increased to 438 (54%) with 362 (46%) older than 1 year. The number of ASO for TGA increased to 44 cases (4400% increase).

Conclusion; This paper discusses the evolution of Paediatric Cardiac Surgery in Libya (a developing country) over these two periods and how newborns with TGA are now operated upon routinely.