Outcomes for surgical repair of tetralogy of Fallot with pulmonary stenosis are often considered to be a useful benchmark for the assessment of congenital surgical programs. This procedure, including preoperative assessment and postoperative management, falls in the middle of the spectrum of difficulty of all the congenital cardiac procedures. Within this anomaly itself, there is a wide spectrum of severity and difficulty. However, it is important to distinguish tetralogy with pulmonary stenosis or "simple tetralogy" from the much more complex anomaly tetralogy of Fallot with pulmonary atresia. Tetralogy of Fallot with pulmonary stenosis is virtually always operable. It is also a progressive condition that is therefore best repaired in early infancy following echocardiographic diagnosis alone.