The majority of babies born with congenital heart disease are now surviving to adulthood. Some have not required cardiac surgery but many have had previous palliation or repair. Because few lesions are "cured" by surgery, these patients need continued expert care to ensure both quality and length of life. Patients need to be treated by physicians with expertise in adult congenital heart disease, with adequate facilities available for both noninvasive and invasive imaging. Access to inpatient facilities also should be available, and a collaborative relationship with pediatric cardiologists, high-risk obstetricians, and anesthesiologists established. Patients need advice regarding endocarditis, employability, exercise, noncardiac surgery, life and health insurance. It is hoped that, with increasing awareness of these patients' problems, adequate lifetime care will be provided for them.