Objective To retrospectively summarize the experience of surgical treatment of valvular heart disease with large left ventricle. Methods The clinical data of 375 cases of valvular heart disease with large left ventricle were collected. All cases were performed operations under general anesthesia with hypothermic cardiopulmonary bypass, including mitral valve replacement in 88 cases, aortic valve replacement in 206 cases and combined mitral and aortic valve replacement in 81 cases. Two hundred and twentyfive cases received tricuspid valvoplasty at the same time. The early postoperative complications, early mortality rate, causes of death and follow-up data were retrospectively analysed. The experience of surgical treatment was summarized on the basis of literature review. Results The early postoperative complications occurred in 97 cases (25.87%), including low cardiac output syndrome (12 cases,3.20％), lung infection (17 cases,4.53%), renal insufficiency (18 cases, 4.80%), ventricular arrhythmia (46 cases,12.27%) and a second operation due to postoperative hemorrhage (4 cases,1.07%). The early mortality rate was 3.20% (12 cases), and the death causes were low cardiac output syndrome (4 cases), ventricular arrhythmia (3 cases), renal insufficiency (3 cases) and lung infection (2 cases). All the other cases were cured and discharged. There was no death during the follow-up (2 months to 1 year), and the cardiac function of these cases was significantly improved. Conclusion The comprehensive preoperative preparation, precise operative procedure, sufficient myocardial preservation and proper management in intensive care unit were the keys to the successful surgical treatment of valvular heart disease with large left ventricle.