Aim: Our aim was to comparatively evaluate the post-operative neurocognitive dysfunction following general and regional anesthesia in pregnant patients with cardiac disease undergoing elective cesarean section. Materials and Methods: Sixty pregnant patients with congenital or rheumatic heart disease undergoing elective cesarean section were divided into two groups, General anesthesia group (Group G, n = 30) and Regional Anesthesia Group (Group R, n = 30). Neuro-Cognitive Tests - Trail Making test A & B, Digit symbol substitution test, Benton visual retention test and Benton visual recognition test were performed one day prior to surgery and at 6h, on day 1 and day 3 post-operatively. Results: Neuro-cognitive tests when compared from their preoperative values to 6h, day 1 and day 3 post-operatively, there was a significant increase (p <-0.001) in both Groups G and Group R. Whereas when compared between the Group G and Group R at pre-operative, 6h, day 1 and day 3 post-operatively there was no significant difference between them (p > 0.05). Cognitive dysfunction occurred in both the groups but it was short lasting in Group R. Post-operative cognitive dysfunction incidence in Group G was 23% as compared to 10% in Group R on day 3. Conclusion: Neurocognitive functions are affected in post-operative pregnant patients with cardiac disease irrespective of the technique of anesthesia. However, recovery is delayed in patients receiving general anesthesia.