Thirty-four young patients (28 male and 6 female) underwent aortic valve replacement between 1972 and 1988. Ages ranged from 11 to 20 years (mean 17.7 years). Including reimplantation in the follow-up period, 40 valves were implanted, among which were 17 (43%) St. Jude, 7 (16%) Bjork-Shiley, and 4 (10%) Carpentier-Edwards. Seven patients (18%) had tissue valve prostheses (4 Carpentier-Edwards, 3 Hancock valves). There was one hospital death (2.9%). Follow-up was obtained in 30 of the 33 hospital survivors, with a mean follow-up of 80 months. In the follow-up period, one patient (3%) had a major thromboembolic event and one patient (3%) had prosthetic valve endocarditis. Six patients (18%) required replacement of the implanted valve; three of these had received Hancock tissue valve prostheses. There were three late deaths, yielding 96% survival at 5 years and 84% at 10 years. Twenty-three of 30 survivors are currently New York Heart Association class I. Aortic valve replacement in young patients can be performed with low mortality and morbidity, and with excellent long-term results.