Long-term follow-up (10 to 13 years) of four patients with anomalous left coronary artery who underwent ligation of the anomalous left coronary artery is presented. Two were operated upon in infancy and the other two at 6 and 7 years of age, respectively. Postoperatively, each is asymptomatic and doing well clinically. The cardiac size on roentgenogram of the chest returned toward normal in each. Abnormalities persist on the electrocardiogram. On treadmill exercise, the electrocardiogram of the two operated upon in infancy showed an abnormal result, whereas the two patients operated upon later in childhood had no electrocardiographic abnormalities.