Pediatric cardiac surgery is a highly challenging medical subspecialty requiring technical precision, adaptability, and extensive multidisciplinary support. Unlike adult cardiac surgery, which often addresses standardized acquired conditions, surgery for congenital heart disease (CHD) in neonates, infants, and children involves unique anatomical and physiological complexities. These patients often need individualized surgical plans, and many benefit from staged interventions to accommodate growth. The steep learning curve for pediatric cardiac surgeons, combined with limited exposure to rare forms of CHD, underscores the importance of mentoring and specialized training. The limited cardiovascular reserve of younger patients makes them susceptible to physiological fluctuations, necessitating precise intraoperative management. Postoperatively, pediatric patients with CHD require intensive monitoring in specialized units and long-term follow-up because of their vulnerability to complications and delayed neurological developments. This field also places considerable psychosocial and financial burdens on families, highlighting the need for comprehensive, family-centered care. Global disparities in access to specialized resources perpetuate inequities in patient outcomes. Addressing these challenges requires a multidisciplinary approach integrating surgical expertise, holistic family support, and policy initiatives to improve worldwide access to care. Such a strategy is essential for advancing outcomes and ensuring equitable treatment for pediatric patients with CHD everywhere.