Tetralogy of Fallot is one of the most common forms of cyanotic congenital heart disease. Thanks to the evolution of surgical concepts and improved intra- and postoperative management strategies, its 30-year survival rate is 90%. However, once the number of these patients has grown, clinicians can face with new challenges. Pulmonary valve regurgitation is the most common long-term complication which eventually requires surgery. Although aortic valve and ascending aorta is mostly overlooked, aortic root dilatation and associated aortic valve regurgitation are rare, but major long-term complications. There are no guidelines or clear evidence-based approaches; only sporadic case series exist in the literature. Herein, we report a 31-year-old male case who was incidentally diagnosed with aortic root dilatation 23 years after total surgical repair of tetralogy of Fallot.