Partial left ventriculectomy and mitral valve repair, alone or in combination, have been used successfully to treat adult patients with end-stage dilated cardiomyopathy, yet the clinical results of this procedure in small children have been described only rarely. We report 2 cases of nontransplant cardiac surgery in small children with end-stage dilated cardiomyopathy The 1st patient received both a partial left ventriculectomy and mitral valve repair; the 2nd received only mitral valve repair. Subsequently, both underwent successful heart transplantation. We believe that nontransplant cardiac surgery can improve clinical status and act as a biological bridge, instead of a mechanical bridge, to heart transplantation in small children with end-stage dilated cardiomyopathy.