Infective Endocarditis (IE) is a known and a well-described complication of congenital and acquired heart disease. Its onset may be related to a procedure (which is commonly dental) or to poor dental hygiene. Use of antibiotics prior to the procedure prevents IE. General awareness of dental hygiene and use of prophylactic antibiotic is as much a responsibility of the Pediatrician as it is of the Pediatric Cardiologist. This article reviews the changing epidemiology, pathophysiology, clinical manifestations, and the microbiology of IE. Duke criteria for diagnosis of IE and the role of echocardiography in diagnosis of IE are discussed. There is special emphasis on the prevention of IE.