Majority of children with complex congenital heart disease are now reaching their adulthood owing to recent medical advances. Of those, adults with Fontan circulation are the representative cases with chronic heart failure who are prone to getting progressive multiorgan diseases, including hemostatic problems, protein losing enteropathy, and hepatorenal dysfunction as well as cardiovascular problems, such as sudden death, arrhythmias, and heart failure. In addition, pregnancy-related issues are emerging in women with Fontan circulation. However, although the related experiences are accumulating, clinicians are still struggle to manage these Fontan-associated issues in their adulthood. In this plenary session, we’d like to share and discuss those current Fontan-associated issues to help guide clinicians in the management of adult Fontan patients.