Since the introduction of balloon atrial septostomy by Rashkind and Miller in 1966, interventional cardiac catheterization has been developed for more than 40 years. With the development of new medical equipment, balloon catheters, stents, various occlusion devices, and the advancing imaging modalities, many congenital and acquired structural anomalies of cardiovascular system can be successfully treated without open chest and/or heart. Basic techniques including dilatation and occlusion are performed percutaneously from the peripheral vessels of inguinal regions under general or local anesthesia with sedation. This article reviews the developing skills and current techniques for treatment of structural cardiovascular defects in Taiwan.