Patients with ventricular preexcitation may have symptomatic arrhythmias (Wolff-Parkinson-White syndrome) which can range from life-threatening, to disabling symptoms or minimal symptoms. Individuals may also be entirely asymptomatic. A rational approach to the management of these individuals is therefore dependent on the clinical circumstances. This review discusses the value and limitations of some of the available noninvasive and invasive investigations which may contribute to the successful management of these patients. In general, investigations are useful for establishing the diagnosis, identifying those patients at risk from life-threatening arrhythmias and providing a rational basis for therapy. The available pharmacologic and nonpharmacologic therapeutic options are discussed.