Pulmonary valve endocarditis is uncommon, so experience of surgical treatment is limited. A case of pulmonary valve endocarditis in a 26-year-old man, with associated extension into the pulmonary valve annulus and vegetations in the main pulmonary artery, is described. This necessitated surgical excision of the main pulmonary artery and pulmonary valve including the root, annulus, and part of the right ventricular outflow tract. The defect was reconstructed with a Shelhigh No-React porcine pulmonic valve conduit.