The population of adults with surgically corrected tetralogy of Fallot (TOF) is increasing. Atrial and ventricular arrhythmias are prevalent, and therapeutical approaches including implantable cardioverter-defibrillators and radiofrequency catheter ablation need to be considered carefully for the prevention of hemodynamic deterioration and sudden cardiac death. Complex anatomy, myocardial hypertrophy, and broad channels of slow conduction may in part explain some challenges regarding risk stratification, and identification/modification of the arrhythmogenic substrate in these patients. The aim of this brief review is 2-fold: (1.) To present insights into characteristics of typical TOF related arrhythmias and (2.) to reflect therapeutical concepts targeting tachyarrhythmias in these patients by focusing on catheter ablation.