Currently, percutaneous pulmonary valve balloon dilation has become the preferred modality for the treatment of pulmonary valve stenosis. It has the advantages of less trauma, fewer complications, and shorter hospital stay. However, it has its limitations, and surgical treatment is required in the following cases: (1) In infants and children with more obvious symptoms of pulmonary stenosis, catheter balloon dilatation is not recommended to avoid damaging their large arteries. (2) In children with pulmonary valve dysplasia, surgery is recommended because of the poor results of catheter balloon dilation and the high recurrence rate. (3) Children with significant right ventricular outflow tract obstruction are recommended for surgical treatment due to the high risk and poor outcome of catheter balloon dilation. (4) In children with very severe pulmonary stenosis, catheter balloon dilatation is also very risky and surgical treatment is relatively safe. (5) Some children with severe pulmonary valve stenosis may have right ventricular dysplasia or right ventricular failure, and catheter balloon dilation alone is not sufficient to relieve symptoms.