In infants and young children with ventricular septal defects (VSD) direct primary closure of the VSD can give very satisfactory results with a mortality that compares well with that of pulmonary artery banding. Twenty-four infants ranging in age from 5 to 29 months and in weight from 4.2 kg to 11.5 kg (9 to 25 lb) underwent intracardiac repair of their defect. Six had an associated atrial septal defect and two a patent ductus arteriosus. Of the four hospital deaths (none younger than 12 months of age), two patients had multiple muscular defects, and all four had a pulmonary artery pressure equal to the systemic with increased pulmonary vascular resistance (over 6 units). The surviving 20 patients showed improvement in their weight, clinical cardiopulmonary status, and electrocardiographic patterns. A curative repair should be considered in the infant with VSD, especially in the presence of associated atrial septal defect.