Objective: This study assessed the advantages of on-pump beating aortic valve surgery in high-risk aortic regurgitation patients. The superiority of this operation was approved in comparison to traditional aortic valve replacement. Material and Methods: Sixteen high-risk aortic regurgitation patients were followed-up prospectively. Seven patients had undergone beating aortic surgery compared to nine patients with traditional aortic valve replacement. Blood samples for Troponin T and creatine kinase-mB (CKmB) were collected at 0, 1, 6, 12, 24 and 48 hours of surgery. Surgery was performed on beating heart and continous normothermic normokalemic coronary perfusion with aortic cross clamping while traditional surgery was done with hypothermic cardioplegic arrest. Results: For both groups there were no significant differences in preoperative echocardiography findings, cardiopulmonary pump time, cross clamp time, intensive care unit and hospital stay times. The mean cardiac troponin T and CKmB values showed significant differences with the protective effects of beating heart aortic valve surgery. Postoperative echocardiographic findings of the patients were encouraging, with preservation of ventricular functions and well-functioning mechanical aortic valve. Conclusion: On-pump beating aortic valve replacement has encouraging results especially in high-risk patients. At the same time, results revealed superiority of this approach in postoperative outcome in comparison to traditional aortic valve replacement.