The aims of this study were threefold: (11 to review the clinical profile of patients with coarctation of the aorta; (iJ) to analyse tbe causes of failure to recognise coarctation of the aorta; and (ii,) to evaluate surgical procedures and outcome. Forty-tbree consecutive patients with coarctation of the aorta were retrospectively analysed. Fifty-one per cent of tbe patients were under 6 months of age. All of them presented with congestive cardiac failure. The diagnosis was confirmed in all of the patients evaluated by echocarruography and cardiac catheterisation. Eehocardiography was shown to be an excellent mode for diagnosis of coarctation of the aorta. The most common reason for missing the diagnosis was failure to take the patient's blood pressure. The surgical technique most often used was subclavian nap aortoplasty (66%). Recoarctation developed in 2 of our patients; both successfully underwent bllUoon dilatation. Five other patients developed systemic hypertension and are currently receiving treatment.