Forty-six patients, 24 male and 22 females, with a mean age of 78.4 years (range 75 to 88) underwent aortic valve replacement (AVR) for severe calcific aortic stenosis during a five year period. Twenty-six patients (56.5%) had combined aortic valve replacement/coronary artery bypass (AVR/CABG) procedures. Bovine pericardial or porcine bioprostheses were used in 47.8% of cases. The mean length of stay in the intensive care unit was 2.9 days (range 2-13) with a mean hospital stay of 12.6 days (range 6-41). Operative mortality rate was 6.5% (3 patients), all in the AVR/CABG group. Complications included pneumonia (8.7%), stroke (6.5%), and complete heart block requiring pacemaker insertion (6.5%). Follow-up of survivors from 11-69 months (mean 34.6) shows 92.9% survival, with 87.2% in New York Heart Association (NYHA) Class I and II. Aortic valve replacement in the elderly population has an acceptable mortality rate and is associated with significantly improved quality of life over the intermediate term.