The development of technique for surgical correction of aortic origin of the right pulmonary artery is described. In the first patient, aged 7 years, the operation was performed via bilateral thoracotomy, with standby for extracorporeal circulation, and the right pulmonary artery was anastomosed directly to the left, using side clamps on both aorta and left pulmonary artery. The currently preferred procedure is to operate as early as possible in infancy, using perfusion at 30 degrees C with ventricular fibrillation and without cross-clamping of the aorta. Wide mobilization of the pulmonary artery probably prevents stenosis at the end-to-side anastomosis.