Abstract: Introduction: Repair of congenital heart diseases has become a routine in infancy because of the physiological benefit of promoting normal growth and development, limiting the pathophysiological consequences of cardiac defects such as volume overload, pressure overload, and chronic hypoxemia. The concept of “fast track” postoperative care postcardiac surgery, predicated on early extubation, has been present for the last two decades. Advances in surgical techniques and postoperative management have altered the expectations for mechanical ventilation following cardiac surgery. Objective: The objective of the current study was to evaluate the timing of first extubation and compare the outcome of patient extubated early with others; we also evaluated the predictors of early extubation in our cohort. Materials and Methods: Between Julys to December 2019, BSMMU, Dhaka, Bangladesh 60 consecutive patients undergoing cardiac surgery were preoperatively selected for post-operative admission in the postanaesthesia care unit (PACU) and were included in this study the PACU pathway. This study included children <1 year of age undergoing surgery for congenital heart disease. Timing of first extubation was noted, and patients were dichotomized in the group taking 6 h after completion of surgery as cutoff for early extubation. The outcome of the patient’s extubated early was compared with those who required prolonged ventilation. Variables were compared between the groups, and predictors of early extubation were evaluated using multivariate logistic regression analysis. Results: One hundred and ninety four (33.8%) patients were extubated early including 2 extubation in operating room and 406 (70.7%) were extubated within 24 h. Four (0.7%) patients died without extubation. No significant difference in mortality and reintubation was observed between groups. Patient extubated early had a significant lower incidence of sepsis (P=0.003) and duration.....................