Introduction: Long QT syndrome (LQTS) is an inherited electrical cardiac abnormality with a prolonged QT interval. LQTS can present early in life and has a 20% association with sudden unexplained infant deaths (SUID). Fetal diagnosis, routine neonatal ECG screening and genetic testing help in early detection. Case history: A term baby boy was sen on day one of life due to bilateral talipes equinovarus deformity . Baby was born to non-consanguineous parents with a weight of 3.165 kgs. Antenatal period was uncomplicated including anomaly scans. On examination, baby was found to have an irregular heart rate and a soft ejection systolic murmur at the left upper sternal edge. Baby’s heart rate was 92 bpm. No pre and post ductal saturation difference noted. There were not anydysmorphic features. Except bilateral talipes deformity , rest of the neonatal examination was normal. ECG showed sinus rhythm and a prolonged QT interval (600 ms). Axis and other segments on ECG were normal. All serum electrolytes were normal. A small osteum secondum Arterial Septal Defect was found on echo-cardiography . Halter monitoring confirmed LQTS. With electrophysiologists opinion oral propranolol 1.5 mg 8 hourly was started and subsequently increased to 3 mg 8 hourly . Genetic studies for definitive diagnosis were not done due to unavailability . Baby’s TSH and hearing screening was normal. Family members were screened with ECGs and were normal. Conclusion: Thorough examination and vigilant monitoring help in early detection of cardiacrhythm abnormalities even in resource poor settings.