Abstract: OBJECTIVE: To investigate the clinical characteristics and surgical treatment of aortic coarctation presenting as simple aortic valve closure insufficiency, to avoid preoperative misdiagnosis, and to provide reference for clinical diagnosis and treatment. Methods: To retrospectively analyze the clinical data of 5 patients with aortic coarctation with preoperative diagnosis of aortic valve insufficiency from January 2005 to May 2012 in Beijing Fu Wai Cardiovascular Hospital, including 4 males and 1 female; median age 41 (34-53) years. 5 cases were diagnosed as aortic coarctation intraoperatively, 1 with simple aortic valvuloplasty, 1 with Wheat surgery, and 3 with Bentall’s procedure. Their clinical manifestations, auxiliary examinations, intraoperative findings, surgical approach and follow-up results were analyzed and summarized. The echocardiogram before discharge in case 1 showed that the transverse diameter of the ascending aorta and sinus was reduced compared with that before surgery, and the aortic valve was well aligned with no significant regurgitation; the remaining 4 patients had good opening and closing of the mechanical valve and a patent prosthetic vessel on repeat echocardiogram and CT. 5 patients were followed up with a median follow-up time of 4 (2-5) years and all survived. All four patients had good mechanical valve opening and closure with no clear perivalvular leak and a patent prosthetic vessel on repeat echocardiography; one case had a small amount of regurgitation in the aortic valve. Conclusion Aortic coarctation showing simple aortic valve closure insufficiency is rare and easily misdiagnosed preoperatively. Careful analysis of the medical history combined with ancillary examinations can avoid misdiagnosis to a certain extent, and it is appropriate to decide the surgical approach according to the degree of aortic intimal tear and sinus destruction during surgery.