To describe trends and outcomes for patients undergoing surgical aortic valve replacement in the Netherlands. The Netherlands Heart Registration database was used to report the number and outcomes of isolated, primary surgical aortic valve replacement procedures performed from 2007 to 2018 in adult patients. A total of 17142 procedures were included, of which 77.9% were performed using a biological prosthesis and 21.0% with a mechanical prosthesis. Median logistic EUROSCORE I decreased from 4.6 (IQR 2.4-7.7) to 4.0 (IQR 2.6-6.0). 120-day mortality decreased from 3.3% in 2007 to 0.7% in 2018. Median duration of follow-up was 76 months (IQR 53-111). Ten-year survival, when adjusted for age, EUROSCORE I, and body surface area, was 72.4%, and adjusted 10-year freedom from reinvervention was98.1%. Additional analysis for patients under the age of 60 showed no difference between patients treated with a biological or mechanical prosthesis in adjusted 10-year survival, 89.7% versus 91.9±%, respectively, (p = 0.25), but a significant difference in adjusted 10-year freedom from reintervention, 90.0±% versus 95.9%, respectively, (p < 0.01). Between 2007 and 2018, age and risk profile of patients undergoing surgical aortic valve replacement decreased, especially for patients treated with a biological prosthesis. The 120-day mortality decreased over time. Patients undergoing surgical aortic valve replacement nowadays have a risk of 120-day mortality of < 1% and 10-year freedom from valve-related reintervention of > 95%.