Background: Congenital heart disease (CHD) is the most common congenital malformations with high mortality and morbidity. The prevalence of CHD reported previously ranged from 4 per 1000 live births to 50 per 1000 live births. In this cross-sectional study, we aimed to document the prevalence of CHD in Langfang district of Hebei Province, China by analyzing data collected by hospitals located in 11 the counties of the district, as supported by a public health campaign. Methods: A total of 67,718 consecutive 3-month-old infants were included from July 19, 2012 to July 18, 2014. Structural abnormalities were diagnosed based on echocardiography findings, including two-dimensional and color Doppler echocardiography results. Results: Of the 67,718 infants, 1554 were found to have cardiac structural abnormalities. The total prevalence of CHD was 22.9 per 1000 live births, a value significantly higher than the previously reported prevalence of 8 cases per 1000 live births. The top five most common cardiac abnormalities were as follows: atrial septal defect (ASD, 605 cases, 8.9 3%.); ventricular septal defect (550 cases, 8.12 parts per thousand); patent ductus arteriosus (228 cases, 3.37 parts per thousand); pulmonary stenosis (66 cases, 0.97 parts per thousand); and tetralogy of Fallot (32 cases, 0.47 parts per thousand). The CHD prevalence differed by gender in this study (chi(2)= 23.498, P < 0.001), and the majority of ASD cases were females. Regional differences in prevalence were also found (chi(2) = 24.602, P < 0.001); a higher prevalence was found in urban areas (32.2 cases per 1000 live births) than in rural areas (21.1 cases per 1000 live births). There was a significant difference in the prevalence of CHD in preterm versus full-term infants (chi(2) = 133.443, P < 0.00 1). Prevalence of CHD in infants of maternal aged 35 years or over was significantly higher (chi(2) = 86.917, P < 0.001). Conclusions: The prevalence of CHD in Langfang district was within the range reported using echocardiography. Echocardiography can be used to early diagnose the CHD.