PURPOSE OF REVIEW: Management of patients with an implantable cardioverter defibrillator (ICD) and ventricular tachycardia (VT) is a common clinical challenge. Suppression is often warranted. Catheter ablation (CA) is being used increasingly with expanding indications, and novel procedural strategies are being investigated for refractory cases. The purpose of the review is to synthesize the evidence for ventricular tachycardia suppression and the modalities. RECENT FINDINGS: Patients with ventricular tachycardia are at increased risk of recurrent events and higher mortality; the risk increases with more events. Catheter ablation is superior to antiarrhythmic drug therapy to reduce VT recurrence in the ischemic heart disease cohort. Acute freedom from VT is typically achievable, but long-term recurrence rates remain high. There has been an expanding role for interventional approaches to VT suppression with improvement in acute success. Achieving long-term VT freedom is difficult, and multiple suppression methods may be needed.