From the newborn period to adolescence, auscultation during a pediatric well-child or sick visit may reveal a murmur. When this occurs, families and patients look to the provider for guidance. It is imperative that the caregiver understand pediatric cardiac murmurs in order to provide either reassurance or further evaluation. If further evaluation is needed, the provider must be able to identify the most likely etiology for the murmur, order the appropriate diagnostic, and educate the family. Etiologies of murmurs range from physiologic innocent murmurs to congenital heart defects that ultimately require surgical intervention. This lecture will review proper auscultation techniques and differentiate innocent from pathologic murmur in regard to sound, diagnostic evaluation and management.