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The aortic coarctation has an incidence of 0.6-0.8/1,000 newborn, with clinical manifestation starting with the neonatal period. In the newborn, the heart congenital malformations associated to heart failure and clinical response early in the first hours of life have a guarded prognosis, needing an early diagnostic and an adequate therapeutic conduct. We present a clinical case of severe aortic coarctation with duct dependent systemic circulation, diagnosed early in the neonatal period. The early treatment with Prostaglandin E1 allowed the maintenance of the haemodynamic balance, the newborn benefiting from surgical correction in the first month of life.