The last decade has generated enormous advances in the diagnostic and therapeutic possibilities for diseases of the pulmonary valve. There have been advances in all age groups from fetus to adult, with not only the development of novel treatments (fetal interventions, new surgical strategies and percutaneous pulmonary valve implantation), but also an improved understanding of the long-term sequelae of pulmonary valve disease. In this article, we discuss treatments of the native valve in the fetus and neonate and the management of the consequences of early interventions in later life, with the particular focus on the introduction of percutaneous pulmonary valve implantation, its follow-up and the development of new devices to treat pulmonary stenosis and incompetence without the need for open-heart surgery.