At the 4th International Neonatal and Childhood Pulmonary Vascular Disease Conference, S. Ramakrishnan, MD, DM, AIIMS presented this lecture about the state of pulmonary hypertension in India, a country that has a vastly underdiagnosed population of patients suffering from congenital heart disease. He discusses how the general barriers to effective health care play out in the field of pulmonary hypertension.