PDA is the most common cardiovascular condition among preterm infants. The incidence of PDA decreases as gestational age at birth increases. Recent evidence suggests that over 50% of infants born before 26 weeks of gestation still have an open ductus beyond 2 months after birth. In term infants, PDAs are observed in approximately 1 in 2000 births, accounting for 5% to 10% of all cases of congenital heart disease. The hemodynamic consequences of PDA vary significantly. In infants where the pulmonary vascular resistance decreases at birth and the PDA remains open, a continuous left-to-right shunt occurs. According to the Poiseuille Law, the shunt flow is proportional to the pressure gradient between the aorta and pulmonary artery and inversely related to the resistance to flow. Among preterm infants, the presence of PDA is associated with various adverse outcomes, including death, which are not typically seen in older and more mature patients. The diagnostic assessment of PDA varies depending on the significance of the ductus. In the case of preterm infants, transthoracic echocardiography is the preferred noninvasive method for evaluating the importance of the ductus. This imaging technique utilizes 2-dimensional and color flow Doppler to assess the size, direction, and volume of the shunt. Recent evidence suggests that varied responses to pharmacological PDA treatments, such as indomethacin and ibuprofen, may be influenced by differences in developmental trajectory, genetic variability of drug-metabolizing enzymes, and drug targets. Surgical ligation of the ductus, performed through the application of a surgical clip via a left posterolateral thoracotomy, offers nearly universal achievement of ductal closure. However, rare cases of ligation of the left pulmonary artery or mainstem bronchus have been reported. Transcatheter closure has become the preferred procedure for definitive PDA occlusion in adults, children, and infants weighing 6 kg or more. In smaller preterm infants, this approach has emerged more recently. Conservative management, which involves avoiding definitive closure and waiting for spontaneous closure, has gained popularity due to the lack of long-term benefits demonstrated by randomized trials of pharmacological and surgical ligation treatments. Various strategies are employed in conservative management to manage the consequences of the ductus, such as fluid restriction, diuretics, systemic afterload reduction, and adjustments in airway pressures or hematocrit levels