The development of pediatric and congenital therapeutic (“interventional”) catheterization procedures is traced from the earliest attempts to the current procedures. Therapeutic cardiac catheterization procedures for pediatric and congenital heart disease have grown from a dream to a reality during only the last three decades. Although some of the technology has come from the adult interventions and has paralleled the development of adult catheter interventions, most of the therapeutic procedures for congenital lesions were developed by a dedicated and persistent group of pediatric cardiologists and originated in the pediatric cardiac catheterization laboratories. Many of the common congenital lesions, which three decades ago required cardiac surgery for treatment, now, as standard accepted therapy, are managed in the catheterization laboratory. The most successful advances have been in the opening of stenotic valves, opening and fixing stenotic vessels with intravascular stents, and, at the opposite extreme, the closure of PDAs, secundum ASDs, some VSDs, and numerous miscellaneous abnormal communications. Although many of these therapies are now the standard of care, all of the catheter therapies in pediatric and congenital lesions are in the infancy of their development and will undergo many improvements and refinements in the future.