Adults with congenital heart disease are a growing population in Colombia and worldwide. Currently, Colombia has a population of more than 51 million inhabitants, with 38.2 million adults, 115,000 of whom live with congenital heart disease of varying complexity. The demographic profile shows that this population with congenital heart disease is mostly young, with ages ranging from 20 to 44 years. Keeping them in optimal health is a challenge, and care involves centralization in special adult congenital heart disease units. This manuscript is a narrative review of the current situation of adults with congenital heart disease living in Colombia. Colombia's current population pyramid is analyzed, and the demographic profile of the adult population with congenital heart disease is described. Finally, the strategies used for developing an adult congenital heart disease unit in Colombia are described, based on the comprehensive model of specialized care for a growing population.