The number of adults with congenital heart disease (ACHD) continues to grow. In a State-of the-Art Review published in JACC: Advances, Christopher W. Valle, MD, and Anne Marie Valente, MD, FACC, et al., on behalf of ACC's Critical Care Cardiology and Adult Congenital and Pediatric Cardiology Member Sections, discuss the current epidemiology of ACHD patients who require care in the intensive care unit and review core physiology and management pearls unique to the critical care of this population. Additionally, they highlight available data on outcomes, identify key gaps in evidence, and address considerations for workforce development and education. Read more.