The scope of this article is to produce concise and practical recommendations relating to physical activity for adolescents and adults with congenital heart disease. The novel approach is to formulate clinically useful recommendations based on haemodynamic and electrophysiological parameters, instead of focusing solely on specific defects. Although the recommendations are aimed at congenital heart disease specialists, it is important to acknowledge that congenital heart disease patients with mild disease are frequently managed by non-specialists.