Background:There was a controversy regarding the effectiveness of balloon pulmonary valvuloplasty as palliation in tetralogy of Fallot.Objective:To report our experience of the procedure, review literature, and discuss feasibility of the procedure.Patients:Seven consecutive patients were examined. Their ages ranged from 1—26 months (mean 12.3 months) and the male to female ratio was 5:2. One of the seven patients had. Down syndrome with tricuspid valve straddling. Hypoxic spells had been observed and β blackers had been given in three of the seven patients before dilation.Methods:A standard technique of balloon pulmonary valvuloplasty was used as previously described. The size of balloon diameter was selected as I20%‐140% larger than the diameter of pulmonary valve annulus. The changes in oxygen saturation level, clinical symptoms, and sizes of pulmonary artery and annulus were examined before and after the dilation and follow‐up.Results:One patient who had had a severe pulmonary stenosis associated with tetralogy of Fallot died of ductal shock during the catheter manipulation. The angioplasty catheter could not be crossed in this patient. Cyanosis was improved in all remaining six patients after the procedure. Hypoxic spells ceased in three patients and withdrawal of propranolol was possible in two patients. The oxygen saturation increased significantly from 74%± 10% to 79%± 8% (P<0.005) immediately after the procedure. In follow‐up angiographies, the values of pulmonary artery index and valve annulus were not significantly increased compared with those, before, dilation. Only two patients had significant increase of pulmonary artery and annulus sizes during follow‐up periods, and consequently, successfully underwent total correction without systemic to pulmonary shunt operation.Conclusion:Balloon pulmonary valvuloplasty is an effective alternative for relief of deep cyanosis and hypoxic spells during short‐term periods, but is not always effective in terms of long‐term growth of the pulmonary artery and annulus. (J Interven Card