Within the past decade, we have witnessed the exponential growth of novel percutaneous transcatheter therapies for the treatment of valvular and congenital heart disorders among others. Consequently, a new field has emerged in the world of adult cardiovascular medicine known as "structural heart disease interventions." We herein provide a contemporary review highlighting many of the important historical landmarks that have set the stage for the development of this new and exciting subspecialty, and introduce a comprehensive overview of the structured training and challenges that will be required to master this field. To our knowledge, our Structural Heart Disease fellowship constitutes one of the very first dedicated training programs in the United States. We believe our experience may be of value to other similar emerging programs across the country and the world.