Objectives: To describe procedural volumes, patient risk profile and outcomes of heart valve surgery in the past 16 years in The Netherlands. Methods: The Dutch Adult National Database for Cardio-Thoracic Surgery includes approximately 200,000 cardiac operations performed between 1995 and 2010. Information on all valve surgery (56 397 operations) was extracted. We determined trends for changes in procedural volume, demographics, risk profile, and in-hospital mortality of valve operations. For a subset from 2007 to 2010, follow-up data was available. Survival status was obtained through linkage with the national Cause of Death Registry. Results: The annual volume of heart valve operations increased by more than 100% (from an estimated 2431 in 1995 to 5906 in 2010). In aortic valve surgery, an increasing use of bioprostheses in all age categories is observed. In mitral valve surgery, 75.4% was performed by repair in 2010. In-hospital mortality for all valve surgery decreased from 4.2% in 2007 to 3.6% in 2010, whereas the mean logistic EuroSCORE remained stable (median 5.8, P = 1.000). Thirty-day mortality after all valve surgery was 3.9% and 120-day mortality was 6.5%. At one year, survival after all valve surgery was 91.6% and a reoperation had been performed in 1.6%. Conclusions: The results of this study provide a comprehensive overview of valve surgery trends and outcomes in the Netherlands. The number of heart valve operations performed in The Netherlands has increased since 1995. The decrease in mortality and unchanged EuroSCORE between 2007 and 2010 might reflect a general improvement in the safety of valve surgery.