Idiopathic ventricular tachycardia (IVT) is monomorphic VT occurring in patients without structural heart disease, often paroxysmal but also incessant. It is classified into outflow tract VT, annular VT, and fascicular VT based on the origin. Right ventricular outflow tract (RVOT) VT is the most common type of idiopathic VT, characterized by a late precordial transition (V3 or later) and narrow R waves in leads V1 and V2 on ECG. Paroxysmal VT is often triggered by exercise, stress, or other stimuli and can be suppressed with β-blockers, verapamil, or propafenone. Most patients have a good prognosis. For symptomatic patients, catheter ablation can be considered.