Delayed sternal closure (DSC) commonly is used after pediatric cardiac surgery in many centers for many reasons including support of the failing myocardium and control of intractable non -surgical bleeding. There is many benefits of this technique as avoiding cardiac compression especially with the presence of myocardial edema, stabilizing postoperative critically ill patients providing easy access for exploration of patients with intractable bleeding. Methods: After open heart surgery on children, the researchers at Mansoura University in Egypt conducted this prospective study in which they analysed the medical records of 45 patients who experienced delayed sternal closure. We reviewed the data including the Indications of DSC, perioperative hemodynamic status, postoperative infection, and mortality. Results: Transposition of great arteries (TGA) with intact interventricular septum was the most common preoperative diagnosis (26.7%). We intended to leave the sternum opened routinely for any neonate after complex cardiac surgery, which represented the most common indication for DSC (42.2%), followed by intractable non-surgical bleeding (28.9%). The mean duration of open chest was 1.98 ± 0.87 days (1 – 5). The mean duration of ICU stay was 9.33 ± 7.01 days (4 - 43 days). The mean duration of hospital stay was 14.78 ± 9.02 days (6 - 51 days). Nine patients had deep sternal wound infection (20%). Sepsis was found in 2 patients (4.4%), and it was the cause of mortality for this two patients (33.3%) of all mortality. Duration of open chest didn't significantly influence deep sternal wound infection. Bypass time and cross clamp time was not significant risk factors for prolongation of the duration of open chest. Duration of open chest was a significant risk factor for prolonged ventilation time p < 0.001, prolonged ICU stay p < 0.001, and prolonged hospital stay p = 0.011. There was no statistically significant relation between sepsis and any of the following, duration of ICU stay P = 0.559, duration of ventilation P = 0.865, duration of open chest P = 0.288, and duration of postoperative hospital stay P = 0.912. The mortality rate was 13.3% (N = 6). Conclusion: A delayed sternal closure is a strategy that is thought to be useful in the management of neonates and babies who are at risk for hemodynamic instability, respiratory instability, or persistent bleeding early on in the recovery process after open heart surgery.