Background: Coarctation of the aorta accounts for 6·8% of congenital heart disease, with an incidence of one in 12 000 live births . Coarctation is a heterogeneous lesion with variability in the degree and site of obstruction. This anatomical variation has an embryological reflection. Up till now, there is no sufficient data regarding the effect of this anatomical component of coarctation of the aorta on the short and term-long prognosis after its treatment (surgical or percutaneous angioplasty). This relationship has to be clarified. Aim of the work: We aim to demonstrate the relationship between the anatomical features of the aortic arch in case of aortic coarctation and the prognosis on the short and long term after its surgical or percutaneous repair. Patients and methods: We conducted a retrospective study that continued prospectively till the end of the work. The children with aortic coarctation who were repaired surgically or percutaneously by catheter-based angioplasty or stenting in the period between 12/2014 and 06/2016 were enrolled. All the descriptive data about this coarctation was collected (echocardiography, CT scan, and/or MRI). An anatomical analysis of these data with their embryological background was done. We have then classified these patients according to their anatomical features of the aortic arch. Follow-up data on short and long-term post-treatment of each anatomical class was gathered. Statistical analysis of these data was held to find out the relationship between this anatomical variation and the follow-up results. Results Thirty cases were enrolled in this study. 15 cases were treated surgically. the other 15 cases were treated interventionally using a balloon or stent. The mean age ± SD was17±12.2 months, the mean systolic blood pressure ±SD pre-treatment was180 ±25 mmHg. 16 cases have hypoplastic aortic arch.13 cases have abnormal aortic arch anatomy (5 have a common trunk of innominate and left common carotid,2 cases have hypoplastic left displaced left subclavian artery, 3 cases have separate right common carotid trunk from the aortic arch, 3cases have a gothic arch with very close aortic arch branches. We found that all cases with hypoplastic aortic arch had recurrent coarctation 6-9m after management. Cases with abnormal arch anatomy had a worse prognosis regarding the persistence of hypertension. There was a negative correlation between the distance (left common carotid and left subclavian arteries) and the duration before coarctation. Conclusion: Arch anatomy may affect the clinical prognosis of coarctation. Abnormal arch anatomy has a worse prognosis. The less the distance between the left subclavian and left common carotid, the better the prognosis and less incidence of re-coarctation