Objective: We tried to determine the prevalence of and expose the significance of clinical evaluation of innocent and pathological murmurs due to underlying disorders and to determine the indication of echocardiographic examination in innocent murmurs’ evaluation and the frequency of congenital heart diseases (CHD) in childhood. Methods: This study was performed on 6035 children between 6-15 ages (3306 boys and 2729 girls) who attended six different elementary schools reflecting various economic groups in Van city in the Eastern of Turkey, which is a developing country. Results: We detected murmurs of different intensities in 243 patients (4%). The results showed that 209 children’s (3.5%) murmurs were accepted as innocent. The regurgitation was detected in single or two valves in 27% (56 cases) of cases with innocent murmurs. Additionally no valve insufficiency or regurgitation was determined in children who had innocent murmurs except these 56 cases. Of patients who had murmurs, 27 children (0.4%) had congenital heart disease and 7 (0.1%) had rheumatic heart disease. In patients who had CHD, mitral valve prolapsus and tricuspid valve prolapsus were found in 48% and 37% of the cases, respectively. Conclusion: Congenital heart disease was found in similar frequency with the literature. Innocent murmurs were found lower than in the literature, but higher than in other studies done in our country. Our study showed that, especially valve prolapsus, other CHD and less frequently rheumatic carditis can be seen in children who look like otherwise healthy. We emphasize that all children especially attending primary education, should be examined by a cardiologist even they have no complaints.