Approximately 800,000 adults in I he United States have congenital heart disease, and their numbers are growing [1]. Echocardiography is the imaging examination of choice for the initial evaluation of these patients. However, this technique does not allow adequate definition of intraatrial baffles in patients who have undergone an atrial switch procedure for transposition of the great vessels or conduits in patients who have undergone a Fontan procedure for treatment of tricuspid atresia. MRI offers excellent anatomic and functional information, but it is time-consuming, is contraindicated in patients with pacemakers, and can be technically difficult in uncooperative and seriously ill patients. Electron beam and 4-MDCT have been described as examination techniques for a variety of congenital heart diseases [2, 3], but little information has been published on the use of MDCT in the evaluation of postoperative anatomy and complications. We present a pictorial review on the use of MDCT in the evaluation of adults with surgically treated cyanotic heart lesions. Recognizing the postoperative appearance of these complicated lesions is important because most adult patients with repaired cyanotic heart disease require lifelong cardiac care.