BACKGROUND One of the most common complications after repair of Fallot's tetralogy is pulmonary valve regurgitation (PR). There are many concepts of treatment, such as surgical, percutaneous, or hybrid pulmonary valve repair. Surgical pulmonary valve replacement is associated with low operative morbidity and mortality and shows very good long-term results. For that reason, it remains the standard of treatment. CASE REPORT We present a case of a 26-year-old male patient who underwent a successful emergent surgical pulmonary valve replacement after a failed percutaneous pulmonary valve intervention, which was performed due to pulmonary regurgitation. CONCLUSIONS Despite the modern (interventional and hybrid) procedures in the treatment of pulmonary valve regurgitation after repair of Fallot's tetralogy, surgical treatment for pulmonary regurgitation still remains the gold standard for young adult patients.