A case control study has been designed to asses the sensitivity and specificity of clinical diagnosis of Rheumatic heart disease and congenital heart disease by consultant physicians and pediatricians .The study was conducted at teaching hospital of Saddam College of Medicine. -Echocardiography M.Mode , 2 D , and Doppler study was considered as a standard reference test. A total number of 206 patients were introduced to the .study, one hundred six patients were with rheumatic heart disease and hundred patients were with congenital heart disease. The patients were diagnosed clinically by referral physician and pediatrician. The patients were subjected to echocardiographic evaluation. Control group of 206 of similar ages and sexes have been considered to be normal by the same referral doctors were also assessed by echocardiography. Results of both two conditions showed asensitivity 82.