Thousands of infants are born in the United States every year with congenital heart defects. Initially, the family is saddened, angry, and concerned about treatment and survival. Eventually, however, questions will emerge about what happened and what the chances for recurrence of another affected child are. In recent years impressive progress has been made in genetic research at the chromosomal and molecular level into the underlying causes for some cardiovascular abnormalities. This challenges health care providers to keep up with new discoveries in the genetics of congenital heart disease to provide patients and families with the correct information or appropriate referrals for genetic evaluations.