Truncus arteriosus is an exceedingly rare congenital heart disease involving conotruncal septum of developing heart. Clinical presentations vary depending upon associated anomalies. Surgical management is extremely challenging and differs with anatomic subtypes. We present a case of Truncus arteriosus -- Vaan Praagh type A4, quadricuspid truncal valve with moderate truncal stenosis and regurgitation, type B interrupted aortic arch who underwent bilateral pulmonary artery banding.