Background: Aortic valve replacement (AVR) remains the only treatment that was revealed to advance the natural history in the cases with severe symptomatic aortic valve disorder. However, aortic valve diseases were challenging in young and adults in middle age persons. The aim of our study: was to compare the mid-term outcomes, quality of life and adverse valve- related events among patients undergoing the Ross procedure and those receiving a mechanical aortic valve . Patients and Methods: This study included patients with aortic valve disease divided into Fifty patients were candidates for ROSS procedure and the other Fifty were for mechanically aortic valve replacement after obtaining the approval of the local ethical committee. Results: Ross patients show statistically significant lower MLHFQ scores compared to Mechanical valve patients; however, a nonsignificant change was found among the study groups in terms of major cardiovascular events or mortality. Conclusion: Mechanical AVR is accompanied by low morbidities and mortalities in both the short and long term. Our data suggest that The Ross operation may be accomplished securely and reproducibly in properly particular cases with lower morbidity and mortality and better quality of life.