Advances in diagnosis, medical management, and surgical treatment of patients with congenital heart disease (CHD) have resulted in a dramatic increase in the number of children surviving to adulthood. Nurses and physicians are starting to recognize adolescents and young adults with CHD as a growing subspecialty group with unique challenges and needs. The question of who should follow these patients remains unsettled, and it is not uncommon to find adolescents and young adults with CHD on both pediatric and adult units. The special management needs of this population are discussed as well as strategies for teaching and counseling.