This chapter describes pulmonary valve lesions: pulmonary stenosis can be an isolated lesion or part of a complex lesion. Mild cases are asymptomatic, moderate to severe stenosis causes dyspnoea, with arrhythmias and right ventricular failure in the late stages. Anaesthetic management aims to avoid tachycardia and manage arrhythmias. Inotropes might be needed in heart failure. Pulmonary regurgitation is common after Tetralogy of Fallot’s repair or balloon valvotomies. Mild cases are asymptomatic, moderate to severe cases present with dyspnoea and right heart failure. Anaesthetic management aims to promote forward flow by reducing pulmonary vascular resistance and to avoid bradycardia.