Four males aged 20-37 years were diagnosed in 1989, 1991 and 1993 with pulmonary valve endocarditis. Three patients were drug addicts, and one had a congenital pulmonary valve lesion with moderate stenosis. The predominant organism in blood cultures was Staphylococcus aureus. As antibiotic treatment of the condition failed, partial or total valvectomy was performed. After surgery, all patients were cured of infection and initial recovery was good. Pulmonary valve resection is the treatment of choice for pulmonary valve endocarditis when antibiotic treatment appears to have failed. The infection was eradicated in all patients, and early and mid-term tolerance of the resultant insufficiency was good, even for total valvectomies. Thus, complete resection of all affected tissue should be carried out. In time, right ventricular dilatation and tricuspid insufficiency developed to various degrees, though all patients remained in sinus rhythm, without development of pulmonary hypertension. Right-sided heart failure occurred in one case, and valve substitution will likely be needed. Analysis of preoperative data did not permit differentiation of those patients who would develop right heart failure.