Congenital Heart Disease (CHD) is the most common birth defects in humans affecting ~1% of live births worldwide. CHDs are structural abnormalities of the heart arising during fetal development leading to abnormal shunt formation and circulation of the pulmonary and systemic circulations. The exact causes of CHDs are not well understood, but a combination of genetic and environmental factors are thought to play a role. CHDs can range from simple defects that may not require treatment, to complex defects that can be life-threatening and require immediate surgical intervention. Over recent decades, surgical and medical intervention has lead to >90% of children with CHD to reach adulthood defining a new population of adults with CHD (ACHD) previously known as Grown up CHD (GUCHD). The anaesthetic management of adults with CHDs (ACHDs) presents a unique set of challenges for anaesthesiologists. The goal of anaesthetic management in CHD patients is to provide safe and effective anaesthesia while minimizing the risks associated with the patient's underlying cardiac defect. This requires knowledge of the patient's anatomy, physiology, and other specifics of their cardiac defect. Importantly, a multidisciplinary approach involving primary care physicians, cardiologists, cardiac surgeons, and anaesthesiologists with ACHD expertise is advised. These patients are at increased risk of morbidity and mortality with abnormal shunting and chronic hypoxemia. This leads to long term physiological changes and complications including haemodynamic instability, congestive heart failure (CHF), pulmonary hypertension (PH), dysrhythmias, threat of cyanotic spells, acid-base imbalances, coagulation defects, abscess induced seizures, meningitis and more. Congenital Heart Disease; Anaesthesia; ManagementThis thesis explores recent developments in anesthetic management of patients with CHDs during non-cardiac surgery. As there is a growing ACHD population, anesthesiologists should be aware of their complex physiologies and subsequent anesthetic management as they encounter them during their clinical practice. This includes knowledge of their anatomy, physiology, and inherent CHD risk. During anaesthetic management they should carry out extensive medical histories and perioperative risk assessment.