This chapter focuses on the ventricular tachycardia (VT) in ischemic and nonischemic cardiomyopathy. VT in the setting of structural heart is a prognostically significant arrhythmia that can lead to sudden cardiac death (SCD). This can occur in two broad settings i.e. VT that arises in the post-myocardial infarction (MI) context, i.e. ischemic cardiomyopathy and VT that arises in patients with nonischemic dilated cardiomyopathy (DCM). In contrast, nonischemic DCM refers to myocardial disease and dysfunction that are not due to MI. The role of medical therapy in the prevention of VT is limited. Beta-blockers and angiotensin converting enzyme inhibitors are the cornerstone of therapy in patients with left ventricle (LV) systolic dysfunction. Catheter ablation has an important adjunctive role in the management of VT in patients with ischemic or nonischemic cardiomyopathy. At present, catheter ablation is usually considered a ‘last resort’ therapy often in the setting of electrical storm following maximal antiarrhythmic therapy. Detailed discussions on the reentrant circuits, mapping techniques and ablation strategies have been discussed in this chapter.