Paroxysmal supraventricular tachycardia is a common arrhythmia with multiple etiologies, including atrio-ventricular nodal reentrant tachycardia, atrio-ventricular reentrant tachycardia, and atrial tachycardia. Treatment of these arrhythmias depends greatly upon the proper diagnosis as well as an understanding of the arrhythmia’s mechanism. A preliminary diagnosis can be often be inferred from the patient’s history along with noninvasive testing and can help guide initial management strategies. Pharmacologic therapy, however, is often limited by side effects, compliance, and marginal efficacy. More definitive treatment of the arrhythmia requires an invasive electrophysiology study to confirm the diagnosis followed by catheter ablation of the arrhythmogenic substrate. The success rate for catheter ablation can approach 95% depending on the mechanism of the arrhythmia and is the treatment of choice for patients with severe symptoms.