This study explored perceptions toward physical activity and sport in the lives of youth with congenital heart disease. Thirteen cardiac participants were interviewed in the presence of their parents, and a process of inductive analysis was conducted. Sport was not considered a valued pursuit despite the belief that it is essential for the attainment of good health. Low-self efficacy and fatigue were influenced by covert fears and exclusion and further decreased the value ascribed to sport and physical activity. Nontraditional activities, support from others, and perceptions of mastery played a crucial role in enabling participation and facilitated the journey toward recovery. Findings are discussed within the context of self-efficacy theory and may inform the design of safe and enjoyable physical activity opportunities for this population. (Contains 1 table and 1 figure.)