The use of catheterization for the diagnosis of congenital heart disease has decreased dramatically in the last decade. The development of two-dimensional Doppler echocardiography has changed the practice of pediatric cardiology, combining exquisite imaging with Doppler-derived hemodynamic information. Angiographic cardiac imaging is required for those areas inaccessible to ultrasonography, such as the distal great arteries and abnormal venous connections, and also in complex postoperative conditions. To further decrease the need for angiography, transesophageal echocardiography, magnetic resonance imaging, radionuclide angiography, and spiral computed tomography have been employed as noninvasive substitutes in those areas. Of these modalities, magnetic resonance imaging appears to be the most promising. Currently, angiography is used almost exclusively for interventional purposes. The increased imaging versatility afforded by these new modalities has important financial consequences, and requires a responsible economic approach. This article compares the role and requirements of invasive cardiac imaging in the catheterization laboratory with those of these newly developed techniques.