To evaluate the practice of heart retrieval, transplantation and the survival rate. We conducted a retrospective study for all the donors and recipients over the period of six years (2000-2005). The data includes donors age, gender, cause of brain death (BD) and ICU stay which we correlated with the outcome of heart transplantation. There were 1,123 declared BD in which families were approached for organ donation during the study period. Consent for donation were obtained in 267 (23.7%) cases, and out of these, only 25 (9.4%) were transplanted as whole heart and 155 (58%) cases were used as source for valves. The remaining 87 (32.6%) cases were not retrieved due to medical, technical reasons and donor/recipient incompatibility. The data for 25 whole heart transplantation shows that the donor's mean age is 31.6 years, while the recipient mean age is 27.8 years. The outcome of the transplantation reveals that 76% (19 out of 25) of them are still active, 5 died and only 1 lost follow up. Evaluation of the 19 active cases indicates that 18 of them are in 'excellent' condition and only 1 reported a 'good' condition. The mean follow up post transplant period for the cases was 19 months. The actual patient survival at two and five year was 80.4% and 67% respectively. The heart transplantation outcome in Saudi Arabia was indeed satisfactory which is comparable to international data; however, more efforts are needed to increase the acceptance rate of heart retrieval and transplantation.