In Cardiocentrum of the University Hospital in Prague-Motol in 1988-1994 anatomical correction of transposition of the great arteries (arterial switch) was performed in 47 neonates aged 4 to 20 days. The aorta and pulmonary artery were transferred into the appropriate ventricle concurrently with reimplantation of the coronary arteries. The surgical technique was modified with regard to the anatomy of the coronary arteries and the presence of associated cardiac defects. Eleven of the 47 neonates (23%) died during the early postoperative period, one patient died two months after operation. Of the last 20 operated neonates only two died (10%) and both had an abnormal insertion of the coronary arteries. Thirty-five children are followed up for 2-45 months following anatomical correction. All are in a very good clinical condition without serious residual findings. The authors describe the protocol of the diagnostic and therapeutic procedure in transposition of the great arteries. They consider anatomical arterial correction in the neonatal period as the method of choice for this disease. The optimal age for anatomical correction in isolated transposition is between the 7th and 14th day and in transpositions with a major defect of the ventricular septum at the age of one month. The surgical results are steadily improving with accumulating experience. The medium-term results of anatomical correction of transposition of the great arteries are very favourable.