BVES is a transmembrane protein, our previous work demonstrated that single nucleotide mutations of BVES in tetralogy of fallot (TOF) patients cause a downregulation of BVES transcription. However, the relationship between BVES and the pathogenesis of TOF has not been determined. Here we reported our research results about the relationship between BVES and the right ventricular outflow tract (RVOT) stenosis. BVES expression was significantly downregulated in most TOF samples compared with controls. The expression of the second heart field (SHF) regulatory network genes, including NKX2.5, GATA4 and HAND2, was also decreased in the TOF samples. In zebrafish, bves knockdown resulted in looping defects and ventricular outflow tract (VOT) stenosis, which was mostly rescued by injecting bves mRNA. bves knockdown in zebrafish also decreased the expression of SHF genes, such as nkx2.5, gata4 and hand2, consistent with the TOF samples` results. The dualfluorescence reporter system analysis showed that BVES positively regulated the transcriptional activity of GATA4, NKX2.5 and HAND2 promoters. In zebrafish, nkx2.5 mRNA partially rescued VOT stenosis caused by bves knockdown. These results indicate that BVES downregulation may be associated with RVOT stenosis of non-syndromic TOF, and bves is probably involved in the development of VOT in zebrafish. Congenital heart disease (CHD) is the most common birth defect, exhibiting a mortality rate of more than 29% 1. Within this group of conditions, the incidence of TOF is 7-10% in the USA 2 , 13.4% in Nigeria 3 , and 16% in India 4. However, the aetiology of TOF has not been fully elucidated. Anatomically, TOF has four distinct structural defects, namely, ventricular septal defect, overriding of the aorta, RVOT/pulmonary artery (PA) stenosis and right ventricular hypertrophy 5. However, embryologically, the defects are thought to be caused by a single developmental error, involving the outflow tract funnel septum shifting left to right or forward, leading to a poor contraposition ventricular septal defect, overriding of the aorta and RVOT funnel stenosis 5-11. RVOT stenosis eventually leads to right ventricular hypertrophy 10. The degree of RVOT stenosis is a key clinical factor for the diagnosis of TOF 10. However, the molecular mechanism behind RVOT/PA stenosis remains under investigation. The development of the cardiac outflow tract has two major cell sources: one is neural crest cells, which provide cells for the distal development of the great artery by migration, while releasing signals to the SHF 7 ; the other