Abstract Introduction The advent of new medical and interventional approaches has recently impacted on the referral for redo surgical operations. Little is known on current practice pattern and outcomes. Purpose We reviewed our institutional experience of 10 years (January 2011–December 2020) in a single university affiliated center to document frequency, outcome, and complications of the various types of redo procedures. Methods Retrospective analysis of a prospectively collected computed institutional database developed according to STS/EACTS recommendations. Results During study period 616 patients were referred for redo cardiac procedures, of which 129 patients underwent either medical or interventional procedures (75 thrombolysis, 22 valve-in-valve, 19 native mitral and or tricuspid percutaneous treatment, 13 paravalvular leakage devices), 459 patients were operated on, and 28 patients were denied any invasive treatment because of futility. Study group included these 459 surgical patients with a mean age of 62±12.7 years (octogenarians 5.6%, female sex 52.8%, diabetes 19.5%, chronic kidney disease 30%, urgent/emergent status 34.8%, third-time sternotomy 9.8%). The EuroSCORE II averaged 25.7±15.4%. Study group patients represented a nearly constant subgroup over the 6890 patients operated over this decade. Most frequent surgical procedures were valve operations, which were accomplished in 48.6% (223 pts), whereas isolated coronary bypass surgery was performed in 1.9% (9 pts) only. Valve thrombosis, mechanical prosthesis malfunction, paravalvular leakage, bioprosthetic failure and endocarditis (87% on prosthetic valve) were the most frequent indications. Combined procedures were performed in 15.2% (70 pts). Aortic root, ascending and arch replacement procedures were performed in 10.9% (50 pts, aortic dissection 7.8%). Cardiac transplantation in the setting of previous cardiac surgery was performed in 13.1% (60 pts including: previous conventional procedures [29 pts], mechanical circulatory devices [28 pts, 25 left ventricular assist device and 3 total artificial heart] and re-transplantation [3 pts]). Other procedures were performed in 10.2% (47 pts). Overall hospital mortality was 23,9%, rates of major complications were: surgical revision for bleeding 2,9%, Acute Kidney Injury (I/F) 17,4%, prolonged mechanical ventilation 12,9%, stroke 2,7%. Age, surgical priority, endocarditis, and heart failure represented the major independent predictors of morbidity and mortality. Conclusions Although percutaneous solutions are increasing their consensus, the rate of redo cardiac surgical procedures remained stable during the last 10 years. Outcomes are satisfactory despite increasingly complex patients features. Careful Heart Team evaluation is mandatory. Funding Acknowledgement Type of funding sources: None.