This chapter focuses on the congenital cardiac lesion of transposition of the great arteries and intends to give an overview of the condition. It is divided into two sections addressing the more common lesion of d‐TGA in part I and the rarer defect of congenitally corrected transposition of the great arteries (ccTGA) in the part II. For both of these lesions the anat‐omy, pathophysiology, natural history, clinical presentation, diagnosis, peri‐operative management, surgical options and outcomes are addressed. As d‐TGA is a common congenital heart defect, it is covered in more detail and emphasis is placed in the peri‐operative management and stabilization of these patients. The Arterial Switch Operation (ASO) is explored as a surgical option with specific intra‐operative anesthetic management for this procedure. There is reference to the post‐operative management of patients whom have undergone an ASO and the immediate and long term complications of this procedure. Part I concludes with a summary of the long term outcomes of the arterial switch procedure. Part II focuses on the variability and complexity of cc‐TGA. The difficulty in establishing optimal surgical management and the variability of surgical approaches are highlighted with specific mention of the double switch operation.