We performed a retrospective cohort study of 26 pregnancies in 16 women with repaired tetralogy of Fallot (rTOF) delivering at the Chelsea and Westminster Hospital and compared them with 104 controls. The rate of antenatal complications was significantly higher in the rTOF group (30 cf. 13%). Use of epidural anaesthesia was higher (67 cf. 25%) in the rTOF group compared with controls, and the length of the second stage was shorter in both spontaneous and assisted deliveries. However, the mode of delivery and neonatal outcomes were similar in both groups. Mean birthweight centile was lower in the tetralogy of Fallot group, 26 versus 58 in the control group (P = 0.000001, Wilcoxon rank sum test). All women whose babies were <10th centile weight for gestational age had moderate to severe pulmonary regurgitation.