Ventricular septal defect is the most common precordial disease in children, accounting for approximately 25% of all precordial diseases. A small percentage of children can heal on their own, usually occurring in children aged 1 to 5 years with simple ventricular septal defects. However, not all children with ventricular septal defects heal on their own. The mechanisms leading to self-healing are complex and are broadly related to age, type and size of the defect, presence of comorbidities or complications, and severity of hemodynamic abnormalities. Ventricular septal defects are most likely to be associated with infection, cardiac insufficiency, and pulmonary hypertension. Once irreversible organic pulmonary hypertension occurs, then the child loses the chance of treatment. Therefore, while waiting for the child to heal on his own, parents and doctors must pay attention to the occurrence of pulmonary hypertension, as well as the degree of its occurrence and the speed of its progression. With the development of medical science and technology, the diagnosis and treatment indications of ventricular septal defect have been greatly improved, such as the application of cardiovascular imaging technology to assess the pulmonary hypertension complicated by ventricular septal defect, which can more accurately establish whether the child needs recent surgery; at the same time, with the increasing development of medical technology, the means of treatment are becoming more and more mature, and the insurance factor of treatment is also increasing. The application of extracorporeal circulation and deep hypothermia technology has significantly improved the success rate of surgery. Therefore, the general recommendation of cardiovascular surgeons for children with ventricular septal defect is to try to wait for the ventricular septal defect to heal on its own, if conditions allow, and to intervene as soon as the child’s condition changes during the follow-up, or if there is no possibility of self-healing, in order to avoid losing the treatment period.