Whenever common ablation strategies for treatment of cardiac arrhythmias fail, the search for alternative concepts becomes essential. Since it has been proven that the sinus of Valsalva (soV) is situated in close proximity to small regions of the myocardium, difficult to access via endocardial ablation, catheter ablation within the soV has become an established treatment option for patients with supraventricular and ventricular tachycardias. Although ablation within the soV is increasingly practiced, larger studies investigating the feasibility and safety of this approach remain rare. In this review, the authors summarize the currently available literature with special focus on safety issues, energy sources, success rates, and other distinctive aspects of ablation strategies within the soV.