Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 2 2024 04 30 132 135 Afrouz Alipour Department of Pediatric, Faculty of Medicine, Mashhad University of Medical Sciences Mashhad, Iran. Behzad Alizadeh Associate Professor of Paediatric Interventional Cardiology, Paediatric and Congenital Cardiology Division, Paediatric Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Bita Zargaran Department of Pediatric, Faculty of Medicine, Mashhad University of Medical Sciences Mashhad, Iran. 2023 05 28 2024 04 30 The coexistence of aortic coarctation, Ebstein’s anomaly, and transposition of the great arteries is an extremely rare occurrence. In this case report, we present a unique instance of complex congenital heart disease in a neonate who exhibited respiratory distress and cyanosis at birth. Echocardiography revealed several significant findings: congenitally corrected transposition of the great arteries, Ebstein’s tricuspid anomaly, moderate-to-severe tricuspid regurgitation, a small muscular ventricular septal defect, and an abnormal left arch with severe coarctation of the aorta. Due to the patient’s unstable hemodynamic status, balloon angioplasty was performed. Subsequent long-term clinical follow-up confirmed the efficacy of this intervention. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1865