Objective: The right vertical infra - axillary incision has been applied for open - heart surgery with a higher cosmetic result and comparable outcomes, and was considered as an alternative to standard median sternotomy. This study aimed to evaluate the efficacy and safety of the right vertical infra-axillary incision for the correction of simple congenital heart defects in children at National Hospital of Pediatric. Methods: From August 2019 to December 2020, a consecutive of patients who underwent open heart surgery via the right vertical infra-axillary incision in our center was collected to this study. Results: There were 99 childrens who underwent open heart surgery using the right vertical infra - axillary incision for simple congenital heart defects correction during the study period. The meanage 52,96 ± 44,97 months (5 - 181) and the mean weight 15,31 ± 8,65 kg (6 - 54). There were 43 patients undergoing ASD closure, 40 patients underwent VSD closure, 8 patients have partial atrioventricular septal defect, 8 patients have partial anomalous pulmonary venous connection with 2 patients underwent modified Warden procedure. The mean aortic cross clamp time and cardiopulmonary bypass time were 40,08 ± 22,70 min (10 - 118) and 60,65 ± 27,18 min (25 - 172), respectively. There were no hospital deaths and late deaths. There was no patient required conversion to sternotomy approach. 1 patient needed reoperation to enlarge PFO with ECMO support due to heart failure, and successfully withdrawn ECMO after 3 days. 1 patient with complete AV block requires permanent pacemaker placement. Follow - up echocardiography showed no residual ASD or VSD, no moderate - severe tricuspid and mitral regurgitation. All patients are in excellent condition with a mean follow - up of 6,91 ± 3,85 (2 - 18) months. The incision healed well, and the thorax with the breast showed no deformity at the latest follow-up. Conclusions: The surgical outcomes of open heart surgery using the right vertical infraaxillary incision is safe and high effective for corrective of simple congenital heart defects in children, with lower trauma and higher cosmetic results. This approach provides a good alternative to the standard median sternotomy with individual selected patients.