Background: Since there is no need for anticoagulation, there is a lower pressure gradient across the valve, and there are better valve hemodynamics, autologous pericardial aortic valve reconstruction is a better option than metallic prosthetic valve replacement. Objective: Ths study aimed to detect the early outcome differences between aortic valve replacement by pretreated autologous pericardium via Ozaki procedure and metallic prosthetic valves. Patients and methods: Between November 2019 to August 2021, 40 patients underwent aortic valve replacement in Kasr Alainy and Kasr Alainy-affiliated Hospitals. Patients were divided into 2 equal groups: AVR group: 20 cases of aortic valve disease requiring metallic aortic valve replacement and Ozaki group: The Ozaki surgery for aortic valve replacement was necessary in 20 cases of dysfunctional aortic valves. An extensive echocardiographic evaluation was carried out prior to release as well as one, three- and six-months following surgery. Other perioperative factors were also evaluated, including the duration of cardiopulmonary bypass and cross-clamp time, the need for anticoagulation, and the gradient of the aortic valve pressure. Results: There were no significant differences between studied groups regards to intraoperative EF% (50.25 ± 7.58 vs 47.95 ± 6.58 %), mean pressure gradient (10.45 ± 1.05 vs 9.75 ± 1.29 mmHg) and peak pressure gradient (20.05 ± 1.92 vs 19.25 ± 2.33 mmHg), duration of ventilation (7.90 ± 1.20 vs 8.65 ± 3.03 hours) and ICU stays (45.25 ± 4.11 vs 51.85 ± 30.43 hours) for mechanical valve replacement and Ozaki group respectively. Conclusion: With good hemodynamics, no anticoagulation, and maintenance of a smaller pressure gradient across the implanted valve, autologous pericardial aortic valve reconstruction using the Ozaki procedure is a viable option to metallic prosthetic valve replacement.