Background: Infective endocarditis is a diagnostic and therapeuticchallenge that ultimately requires surgical intervention in 20% of all cases.Decisions regarding the indications for surgery, the timing, and the evaluation ofthe patient’s ability to withstand the contemplated operation are complicateddecisions requiring appropriate guidelines and sound judgment based uponextensive clinical experience.Patients and Methods: In this study we followed 20 patients diagnosedwith definite infective endocarditis according to the modified Duke’s criteria andunderwent cardiac surgery between June and December 2006. Clinical, laboratoryand echocardiographic data were reported before surgery. Timing, type, indicationfor surgery and other intra-operative and post-operative variables were alsoreported.Results: Rheumatic heart disease was the most common underlying cardiacrisk factor (90% of patients), 75% of the patients had native valve endocarditis(NVE) and the remaining 25% had prosthetic valve endocarditis. The mostcommon indications for surgical intervention were congestive heart failure (60%)and uncontrolled infection (60%). 90% of our patients were operated upon onelective basis. The most common post-operative complication was low cardiacoutput syndrome (15%) and new renal impairment. We had 6 mortalities (30%).The most common cause of in-hospital mortality was congestive heart failure andcardiogenic shock.Conclusion: Preoperative renal impairment, abnormal white cell count,congestive heart failure and prosthetic valve endocarditis were associated withpoor outcome. Further prospective studies with larger sample size are needed tostudy the actual prognostic value of other perioperative risk factors especially thebenefit and optimal timing for surgical intervention.