Interventional cardiac catheterization offers increased therapeutic options to many patients with congenital heart disease. Over the past year encouraging results have been reported in hundreds of patients with interatrial communications, patent ductus arteriosus, and pulmonary artery stenosis requiring stenting. The Amplatzer (AGA Medical Corporation, Golden Valley, MN, USA) family of atrial septal, ventricular septal, and ductus occluding devices shows particular promise. Other studies support the efficacy and safety of established procedures such as balloon valvuloplasty and coarctation angioplasty. In some areas, such as transcatheter perforation of atretic pulmonary valves and endovascular stenting for coarctation of the aorta, our technical abilities may be advancing faster than our understanding of the ultimate clinical impact of our treatment. As interventional cardiac catheterization procedures continue to develop, they must be evaluated carefully against alternative treatments.