Aspergillus fumigatus endocarditis developed in a 2½-year-old girl after repair of tetralogy of Fallot. There have been 14 other cases of Aspergillus endocarditis in children described in the literature. Fever and embolic phenomenon, particularly to the CNS, were the most common presenting manifestations. Consumptive coagulopathy developed in this patient as it has in other children and should suggest the diagnosis of Aspergillus endocarditis inasmuch as blood cultures are uniformly negative. Antemortem diagnosis was made in four of 15 patients. Only one patient survived the infection. Environmental surveillance is crucial when a case is encountered. Survival of the infected patient occurs only with early diagnosis and surgical removal of the infected tissue.