Most congenital heart disease is the result of multiple genes interacting with the environment, which means that a parent with congenital heart disease does not directly cause the disease in their child. Congenital heart disease is a condition in which the heart and large blood vessels develop abnormally in the fetus and the lesions are present at birth, referred to as congenital heart disease. Developmental abnormalities include abnormal anatomy or failure to close channels that should close automatically after birth (which is normal in the fetus). The causes of congenital heart disease are complex and no definitive conclusions have been reached. The four influencing factors that are more recognized by research include genetic factors, environmental factors, drugs, and disease factors. However, genetics does not account for a high proportion, only 8%. In the case of trisomy 21, for example, about 50% of patients with this disease have congenital heart disease. Most cases of pure atrial septal defect, ventricular septal defect, patent ductus arteriosus, and tetralogy of Fallot show polygenic inheritance patterns, and it is not uncommon for siblings to have the disease at the same time or for parents and children to have the disease at the same time, and the nature of the disease is very similar. The mother’s exposure to environmental chemical and physical factors during pregnancy, exposure to teratogenic drugs, viral infections or co-morbidities such as diabetes mellitus can have an important impact on the development of congenital heart disease. In conclusion, it is not conclusive whether congenital heart disease is inherited, but genetics is one of the risk factors for congenital heart disease.