Patient with congenital heart disease are susceptible to infective endocarditis, and bacteremia following dental procedures may lead to infective endocarditis is these patients. Therefore prophylactic antibiotics are recommended for patients with congenital heart disease who are undergoing dental procedures that are associated with infective endocarditis. In 1997 American Heart Association revised guidelines for a prophylaxis against infective endocarditis. The new American Heart Association recommendations for the prevention of infective endocarditis represent a substantial departure from past guidelines. Major change involve the indications for prophylaxis, antibiotic choice and dosing that may reduce bacteremic risk. Previously, antibiotic prophylaxis was suggested for dental procedures associated with any amount of bleeding. Now only those that are associated with significant bleeding are recommended for prophylaxis as dictated by clinical judgement. Recommended antibiotic prophylaxis regimens now consist of a single preprocedural dose, no second dose is recommended. This report presents three cases of dental treatment of patients with congenital heart disease under the most recent American Heart Association recommendations for antibiotic prophylaxis.