Background: Sudden death in infants has a wide differential, but most often has no clear etiology. Most of the time after a complete autopsy cause of death remains unascertained in most infant deaths. Case presentation: This is a case about an 8 day old infant who was found deceased in bed. After a complete autopsy complex congenital cardiac abnormality was identified. The principal anomaly was found to be the interrupted aortic arch, where the distal end was supplied through the patent ductus arteriosus from the pulmonary artery, along with right ventricular hypertrophy. There was evidence of moderate stenosis of the duct. Other findings were a patent foramen ovale, a perimembranous Ventricular Septal Defect (VSD), anomalous location of the pulmonary arteries and a congenital bicuspid valve. Conclusion: This case illustrates the necessity of a proper pre-natal screening to prevent infant deaths and the necessity of complete autopsy to post-mortem diagnosis perinatal deaths.