Common arterial trunk is relatively a straightforward diagnosis on echocardiography. We describe a neonate who was referred to our centre as a case of common arterial trunk but on evaluation was found to have pulmonary atresia with ventricular septal defect and aortopulmonary window, for which he underwent repair with Barbero-Marcial technique. These two conditions differ anatomically and embryologically, and careful echocardiographic evaluation will help in diagnosis and appropriate management.