This week we delve into global pediatric cardiology and review a massive and important work from the Global Burden of Disease study group assessing the trends in congenital heart disease in the world from lower income nations to higher. How has the prevalence of congenital heart disease changed over the past 30 years? How are countries faring in their treatment of congenital heart disease? What are some strategies to address global inequities in care? We discuss these and other questions with the corresponding author of this work, Professor Craig Sable of George Washington University. doi: 10.1016/S2352-4642(19)30402-X