This study evaluated the long-term outcomes of the Ross procedure in neonates and infants with aortic valve pathology demonstrating good post-discharge survival and minimal need for reintervention. Neoaortic dilatation initially peaked but normalized over time, with a high rate of freedom from moderate or greater neoaortic regurgitation (86 percent at 15 years). These findings suggest that the Ross procedure may be a viable option for neonates and infants with aortic valve disease, offering durable outcomes and low rates of autograft reintervention.