BACKGROUND: Criss-cross heart (CCH) is considered as one of the most complex, challenging, and exceptionally rare congenital heart diseases (CHDs). Criss-cross heart is defined by the twisted atrioventricular connection and the crossing of inflow streams to both ventricles, caused by the rotation of the ventricular mass along its longitudinal axis. The treatment depends on the anatomical complexity. Diagnosis of CCH is difficult, and interpretation of imaging results may be challenging. CASE SUMMARY: A one-year-old girl presented with cyanosis and abnormal heart sounds. We report a patient with complex congenital CCH who underwent successful biventricular repair using multimodality cardiac imaging, including echocardiography, cardiac computerized tomography, 3D printing, and 4D flow-CMR (cardiac magnetic resonance). DISCUSSION: Criss-cross heart is one of the most complex and rare CHD. Multimodality cardiac imaging is essential for finding the answers and providing better care for complex CHD patients.