Transcatheter therapy of structural heart disease is advancing rapidly. Due to the less invasive approach, transcatheter techniques have replaced surgery as standard procedure for atrial septal defect and patent foramen ovale closure. Evolving interventional techniques allow treatment of paravalvular leaks, ventricular septal defects and valve replacement. Until recently, therapy for these diseases was limited to patients in whom severe comorbidities lead to contraindications to surgery. Techniques to treat heart failure caused by left ventricular aneurysms or to prevent cardioembolic stroke by percutaneous occlusion of the left atrial appendage in patients with atrial fibrillation are emerging. This article reviews current indications and recent developments in interventional treatment of structural heart disease.