Objective To review our experience of surgical treatment for postinfarction ventricular septal defect. Methods From 1990 to 2004, 22 patients with postinfarction ventricular septal defect underwent surgical treatment. There were 15 males and 7 females with a mean age of (62.2?7.3) years (from 52 years to 72 years),19 had anterior ventricular septal defect and 3 had posterior VSD, and there were 18 cases with left ventricular aneurysm.10 patients also had introaortic balloon pumping in the early experience. In all the patients cardiac function were in NYHA class III～IV. Results There were 8 operative deaths (35%). There were 7 operative deaths before 1999 and 1 case after 1999. The other patients are clinically asymptomatic after surgery, and the cardiac function is in NYHA class I～II. Conclusion Postinfarction ventricular septal defect is an infrequent but serious complication of myocardial infarction. Surgery is the best way to treat this condition. A coronary angiography should be performed in all patients who can be stabilized hemodynamically and myocardial revascularization should be performed in patients with significant coronary artery stenosis.