Abstract: Objective　To investigate the changes in bone age, and the correlation between the changes in structure and function of cardiovascular and bone age index in children with left to right shunt congenital heart disease (CHD) such as atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). Methods One hundred and thirty children diagnosed CHD had been enrolled, including 52 cases of ASD, 46 cases of VSD and 32 cases of PDA. The cardiac structure and function indicators had been detected by ultrasonic. The anteroposterior film of left hand and wrist had been taken. The bone age had been assessed according to “China children bone age score” atlas, and the bone age index (BAI) had been calculated. The differences of bone age among each group had been compared. The linear correlation of the cardiac structure and function indicators with BAI had been analyzed. Results The BAI was statistically different among ASD, VSD and PDA groups (P<0.05). The BAI of PDA group was higher than those of ASD and VSD groups (all P<0.05). The BAI was also statistically different among the groups with different pulmonary artery pressures (P=0.000). The BAI was higher in small defect size group than that in large defect size group (P=0.002). The defect size was negatively correlated with BAI in both ASD and VSD groups (r=-0.48, -0.54, all P<0.05), The pulmonary artery systolic pressure and pulmonary-to-systemic blood flow ratio (QP/QS) were negatively correlated with BAI in ASD, VSD and PDA groups (r=-0.64--0.38,all P<0.05). Conclusion The bone age and BAI of children with left to right shunt CHD are significantly lower than those of healthy children of the same age . The extent of bone age delay is related with PASP, defect size and shunt volume in children with left to right shunt CHD.