Background and aims: Congenital anomalies are as the major causes of stillbirths, neonatal death, disability and childhood health problems all over the world. The aim of this study was to determine the incidence and pattern of congenital anomalies in newborn during the first 24 hours of life in Shahid-Madani hospital, Azarshahr, Tabriz, during two periods 2002-2003 and 2012-2013 years. Methods: This is a records-based descriptive study with 4515 newborns who were delivered at Shahid-Madani hospital. Results: The incidence of congenital anomalies in newborns during 2002-2003 and 2012-2013 years was 1.31 and 1.06 respectively. We found that the incidence rate of congenital anomalies has declined during one decade, and also the pattern of these has varied. In 2002-2003, the most common anomaly was musculoskeletal system anomaly whereas in 2012-2013, the genitourinary system was the most frequent anomaly. Conclusion: Our findings showed incidence and pattern of congenital anomalies have changed during one decade. Research into the etiology, prevention and prenatal care planning must focus on in prevalent congenital anomalies in this city
