Over the last 40 years, we have witnessed an impressive revolution in the management of congenital heart disease (CHD). The major factors contributing to this advance include: enhanced diagnostic abilities, improved surgical procedures, sophisticated intensive care and finally better understanding of natural history of CHD. Recent epidemiological studies have documented that although CHD still remains the principal cause o death among infants, a significant increase in the number of patients with heart defects who survive into the adulthood have been observed. Nowadays, for the first time, the number of adults with CHD equals the numbe of children with this defect. Tetralogy of Fallot (TOF) is one of the most frequent congenital cyanotic heart diseases treated with either corrective or palliative surgical techniques. Successful operation followed by specialized care enable patients to have almost normal life expectancy. In the current paper, we have provided the update on the management, diagnostic approach and treatment of adult patients after the TOF correction. Figures present typical problems related to the echocardiographic evaluation.