Permanent His bundle pacing prevents ventricular dyssynchrony in patients who depend on ventricular pacing and can provide an alternative means to implementing cardiac resynchronization therapy in patients with bundle branch disease and congestive heart failure. Adoption of His bundle pacing, however, has lagged in part due to perceived and real challenges in performing the procedure well and durably. This article focuses on what is required to get on the learning curve and developing technical competence.