Over the past three decades Icelandic children with congenital heart defects have been operated abroad. In 1990 the first infant with congenital heart defect underwent surgical correction here in Iceland that otherwise would have been transported to a foreign country. This paper summarizes our experience with children with congenital defects who have been operated in Iceland. There were 26 patients who underwent 28 surgical procedures, the ages were from three days to 18 years, median 10 months. Fourteen patients had coarctation of the aorta, four patients with complex defects underwent shunt operations, four patients had atrial septal defects and four patients underwent other operations. The 30 day mortality rate was 3.8% (one patient with complex defect died after shunt placement). There was one late death from progressive heart failure in spite of successful initial surgical palliation. Cost analysis is presented in the paper. In conclusion the overall results are encouraging and acceptable for correcting congenital heart defects here in Iceland and is cost effective.