Twenty-five cases with ruptured aneurysm of sinus of Valsava were detected by color Doppler sonography and twenty-four cases undenwent surgical repair. In twenty-three cases, the sonographic findings of the site of the aneurysm and the chambers into which aneurysm ruptured were coincident with the surgical findings. The accuracy was 95.8%. The size of the aneurysm and the diameter of the ruptured site detected by ultrasound were correlated well with surgical findings. The associated lesions obtained by ultrasound were completely identical with surgical findings. Color Doppler flowing imaging has special value in diagnosing the ruptured aneurysm of sinus of Valsalva.