Surgical repair has a dramatic impact on the prognosis of aortic coarctation. However, in many units, endovascular repair by balloon angioplasty or stenting has become the primary treatment. Short-term results are excellent but there are few data on later outcome. Care needs to be exercised in patient selection, and although major complications are rare, when they do occur they may be devastating. This article reviews our current practice for the assessment selection and follow-up of these patients.