Objectives: The objective was to verify the validity of transthoracic echocardiography (TTE) probe for guiding the central venous catheter placement and to ascertain whether the ultrasound (US) guidance is superior to the landmark technique in terms of success rate, procedure time, and complication rate. Design: Prospective, randomized. Setting: Tertiary care, superspeciality hospital, single Institute. Participants: Pediatric cardiac surgical patients. Interventions: The study included 105 patients 10 kg did not reveal any differences in the above parameters. Conclusion: The success rate of IJV cannulation in infants and children is not improved with US guidance. Significantly better success rate was observed with the landmark technique as compared with the US guidance. On sub-group analysis, this difference was not observed in children weighing >10 kg.