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Pulmonary autograft, or Ross procedure, is performed by supplanting a diseased aortic valve with the patient’s own pulmonary valve. Reconstruction of the right ventricular outflow tract is then completed using a pulmonary homograft. To our knowledge, infective endocarditis occurring decades after the Ross procedure has not been reported. Diligent echocardiographic examination can be crucial to ensure prompt treatment and avoid the 25% mortality rate associated with infective endocarditis. Clinical suspicion should remain high in those with a pulmonary autograft history. In this article, we report the case of a 39-year-old patient with infective endocarditis presenting 22 years after Ross procedure.