Background: Congenitally corrected transposition of the great arteries (CCTGA) is associated with spontaneous AV block and pacing-induced cardiomyopathy. His bundle pacing (HBP) is a potential alternative to conventional CRT.Objectives: To determine the outcomes of HBP for CCTGA.Methods: Retrospective data were collected from 10 international centers.Results: HBP or left bundle branch pacing (LBBP) was attempted for 15 CCTGA patients (median 23 yrs, 87% male). Prior surgery had been performed in 5 and chronic ventricular pacing in 6. Conduction system pacing (HBP=11, LBBP=2; non-selective in 10, selective in 3) was acutely successful in 13 (86%) without complication. In 9 cases, electro-anatomical mapping was available and identified the distal His bundle and proximal LBBs within the morphologic LV below the pulmonary valve separate from the mitral annulus. The median implant HV interval was 42 ms (IQR 35 - 48), R wave 6 mV (IQR 5 - 18) and threshold 0.5V (IQR 0.5 - 1.2) at median 0.5 ms. The QRSd was unchanged as compared to junctional escape rhythm (124 vs 110 ms, p=0.17) and decreased significantly compared to baseline ventricular pacing (112 vs 164 ms, p<0.01). At a median of 8 months, all patients were alive without significant change in pacing threshold or lead dysfunction. NYHA class improved in 5 patients.Conclusions: Permanent conduction system pacing is feasible in CCTGA by either HBP or proximal LBBP. Narrow paced QRS and stable lead thresholds were observed at intermediate follow-up. Unique anatomical characteristics may favor this approach over conventional CRT.