Adults with congenital heart disease (CHD) constitute a patient population that has grown rapidly, due to advances in diagnosis and treatment of children with CHD. Though ideally served by cardiologists with advanced training in congenital conditions, adults with CHD often receive the majority of their care from primary care physicians and general cardiologists. These patients often have unique clinical presentations. An understanding of available therapeutic modalities can assist clinicians in the timing of subspecialty referral. This review focuses on the unique challenges of cardiac catheterization and the role of percutaneous interventions in adults with CHD.