As women with congenital heart disease (CHD) approach childbearing age, issues such as pregnancy and contraception need to be addressed. Women with CHD represent a heterogeneous population. While some have simple cardiac lesions and thus have contraceptive risks that are no different from those of the general population, others have complex, multisystem disease such that incorrect contraception advice can be associated with serious health consequences. Choosing a contraceptive requires consideration of the risk of pregnancy; the available contraception options; their risks, failure rates, and benefits; and the preferences of the woman. This review focuses on contraceptive selection in women with CHD.