A review has been undertaken of the number and types of surgical procedures performed in the Department of Cardiac Surgery of the University of Cape Town during the 11-year period 1971-1981, together with data on associated mortality. A yearly average of 560 operations was carried out, of which 75% were for acquired and 25% for congenital heart disease. The number of patients treated continues to rise, from 434 in 1971 to 690 in 1981. There has been a slight reduction in the overall average yearly mortality, from 6.1% between 1971 and 1975 to 5.0% between 1976 and 1981. There was a significant increase in the number of valve replacements in 1975 and 1976 and a more recent, continuing increase in operations for ischaemic heart disease, which now form 19% of the total operations. In both these groups the average yearly mortality has fallen during the period of study. The number of operations each year for congenital heart disease has remained fairly constant, but, disappointingly, there has been no significant reduction in mortality.