Over the past 5 years, the global epidemiology of congenital heart disease (CHD) indicates overall excellent survival rates and a growing population of adults with CHD. Long term issues including procedural re-intervention, neurodevelopmental issues, psychosocial outcomes, quality of life, and exercise participation highlight the importance of surveillance and ongoing follow-up. At the other end of the age spectrum, advancements in fetal interventions to treat CHD have reduced in utero demise and improved post-natal outcomes. Multimodal cardiac imaging through three-dimensional echocardiography, enhanced magnetic resonance imaging (MRI) protocols, and cardiac computed tomography (CT) offer various perspectives to inform care more comprehensively. From a cardiac catheterization standpoint, multiple percutaneous devices have become available and allow a growing number of patients to avoid surgical procedures. Advances in genetic testing have shed new light on syndromes previously said to be idiopathic/unknown, identified children at risk of aortopathies, informed cardiomyopathy screening, and offered clues regarding underlying causes following sudden unexplained death. Pediatric dyslipidemia has increased in prevalence with new Canadian clinical practice updates available to address diagnosis and management.