Purpose of reviewChildren and adolescents with congenital heart disease (CHD) have historically been restricted from vigorous exercise or competitive sports. With our growing understanding of the benefits of exercise and sports participation, we aim to review current recommendations for safe sports participation in children and adolescents with congenital heart disease.Recent findingsRecently published studies identify obesity to be highly prevalent in patients with CHD, especially as they age. This is more evident if the patients lead a sedentary lifestyle or are restricted from engaging in exercise. Recently published guidelines from American and European organizations offer disease-specific recommendations to allow for safe sports participation in children and adolescents with CHD.SummarySports restriction in children with CHD can have negative health and psychosocial consequences in an already vulnerable population. For patients who wish to participate in competitive sports, a comprehensive clinical evaluation is necessary to determine if participation is possible and to minimize risk associated with participation.