Abstract: Harmful periconceptional environmental exposure is a critical environmental risk factor for congenital heart disease (CHD) in offspring. This paper incorporates 97 relevant literatures to systematically review epidemiological and mechanistic research advances regarding the correlation between periconceptional environmental exposure and offspring CHD over the past five years. Current evidence indicates that maternal exposure to chemical contaminants including air pollutants, polycyclic aromatic hydrocarbons, heavy metals, pesticides and environmental endocrine disruptors during the periconceptional period elevates the risk of CHD in offspring; physical environmental stressors such as light pollution and extreme temperatures also impair fetal cardiac development. Various pollutants disrupt normal morphological development of embryonic hearts by inducing oxidative stress, inflammatory responses, mitochondrial damage, endocrine disorders and epigenetic abnormalities. Existing research has several limitations: the interaction of combined multi-pollutant exposure, molecular mechanisms underlying placental transport of pollutants, and exposure-sensitive windows specific to distinct CHD subtypes remain to be further explored. Future studies should establish assessment models for co-exposure to multiple pollutants and elucidate pathogenic pathways via molecular biological techniques, so as to provide theoretical evidence for the preconceptional and antenatal prevention and control of CHD.