In this review, I will address the problem as to whether children with disease of the aortic valve should undergo repair, or be put forward for the Ross procedure. So as to put this debate in the correct framework, we need to evaluate all the options for aortic valvar disease. These include not only the Ross procedure, involving the insertion of a pulmonary autograft, and valvar repair, but also the option of replacing the valve with a biological or mechanical prosthesis.