Congenital heart diseases (CHD) in adults are uncommon. Especially Cyanotic CHDs (CCHD) in the adult is very rare. We had an adult patient with central cyanosis, pan-digital clubbing and systolic murmur over the left parasternal area. Assuming it to be a case of Tetralogy of Fallot (TOF), being the commonest with these features in adults, we admitted him. On detailed elicitation of the history, perusing his old records, and with fresh investigations, we diagnosed it to be a case of Double Outlet Right Ventricle (DORV) with pulmonary hypertension. On reviewing the literature, we found that DORV in children has a very poor prognosis; they do not usually survive to an adult unless operated¹. Moreover, this patient had developed the typical complications “Paradoxical embolism” and “secondary polycythemia”. He had multiple cerebral abscesses with recurrent generalized convulsions.