Junctional tachycardia is recognized in three distinct clinical scenarios i.e. as an incessant infantile arrhythmia (congenital junctional ectopic tachycardia), as a transient arrhythmia following repair of congenital heart disease (postoperative junctional ectopic tachycardia) and as a sporadic, often paroxysmal arrhythmia in adolescents and adults. Congenital junctional ectopic tachycardia, postoperative junctional ectopic tachycardia and junctional tachycardia in adults are the different clinical syndromes of junctional tachycardia. The congenital and postoperative forms of junctional ectopic tachycardia may carry a poor prognosis unless promptly treated. Amiodarone is often required. Conversely, the adult forms of Junctional tachycardia generally carry a benign prognosis and often respond to beta-blockers. When medical management is ineffective, ablation of the JT focus may be considered.