Objective To analyze pulmonary blood supply in congenital heart disease with tetralogy of Fallot (TOF) and pulmonary atresia in young children. Methods The clinic and imaging data of 94 cases of congenital heart disease with tetralogy of Fallot (TOF) and pulmonary atresia were analyzed, aged 2-26 (11.25±8.24) months, from January 2004 to January 2007 Results There were 51 cases with pulmonary blood flow only from ventricle, 27 cases with pulmonary blood flow only from patent ductus arteriosus (PDA) and/or aortopulmary collateral arteries (APCAs), and 16 cases with pulmonary blood flow from both pulmonary and systemic arterier. There were no significant differences in the incidence of PDA and the degree of pulmonary stenosis (P>005). The differences were significant between the incidence of APCAs and the degree of pulmonary stenosis (P<0.05). Conclusion The source of pulmonary blood in congenital heart disease with TOF and pulmonary atresia is complex. The incidence of aortopulmonar