Heart transplantation in Iran was first performed in July 1993. Since then, Shariati University Hospital has been representing the most active center of cardiac transplantation in Iran and one of the major sites in the Middle East. This is a comprehensive review of our 15-year practice registry to make a scheme of our record and achievements. Clinical data on all consecutive transplanted patients from department of cardiac surgery, Shariati University Hospital, Tehran, Iran over the last 15 years were reviewed. Descriptive and analytical statistics were extracted in regard of recipients, donors, surgical characteristics, and current status of patients on follow-up. Total number of 90 patients was transplanted since 1993; 11, 32, and 47 in three 5-year periods respectively. Mean age of recipients was 29.30 ± 13.17 years. Motor-vehicle accident was the main cause of brain death of donors (48.8%). The most common indication for surgery was idiopathic dilated cardiomyopathy (75.5%). Mean survival rate has been 6.66 ± 0.87 years. 1-year and 5-year survivals had a rising trend through the 5-year periods. Acute allograft rejection and infection were the two major events complicating our transplants. This study shows that despite a vast variety of obstacles we have passed the primitive milestones. The number of transplants is increasing at a higher rate in recent years, and patients’ survival rates and outcomes seem to be improving.