Ozaki procedure or aortic valve neo-cuspidizationbasically includes replacement of aortic valve cusps bythree native autologous pericardial cusps. Its midtermoutcomes have been published previously.[1] This videoarticle presents the operative technique in a stepwisemethod.[2]In our clinic, this operation was performed during12 years from April 2007 to March 2019, and morethan 1,100 patients were operated. The mean age ofthe patients was 67.7±14.9 years. The etiology wasaortic stenosis in 61.7%, aortic insufficiency in 31.1%,and both in 7.2% of the patients. The mean aorticcross-clamp and cardiopulmonary bypass times were106.1±30.3 and 151.3±36.9, respectively. The overallsurvival rate is 84.6% and freedom from reoperation is95.8% at 12 years.