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The most important causes of mortality and morbidity after cardiac transplantation are cellular and humoral rejections. They need to be diagnosed early and treated appropriately. Although different methods for recognizing rejections after heart transplantation are used, gold standard method is still endomyocardial biopsy. We wanted to present our endomyocardial biopsy (EMB) results and complications that we routinely perform in our clinic after heart transplantation.Endomyocardial biopsy is performed in our clinic in order to evaluate cardiac transplant rejection. A total of 251 endomyocardial biopsies were performed on 31 of the 37 pediatric patients undergoing cardiac transplantation in our clinic. Approximately 20 of the biopsy procedures were performed through the right internal jugular vein and the rest were through the right or left femoral vein.During this procedure, myocardial perforation in one patient, hematoma in the groin requiring treatment in one patient, and fat tissue in place of myocardial tissue in 2 biopsies were not evaluated for rejection. There was no mortality during the procedure. As a result of these biopsies, 25 cellular 1R, 9 cellular 2R, 3 cellular 3R, 2 suspicious cellular, 10 humoral, 3 suspicious humoral rejection were determined and appropriate treatments were given.The gold standard method for monitoring cell and humoral rejections in patients with heart transplant is still EMB. EMB is an invasive and safe method and is an important method for recognizing rejections. It is important to develop non-invasive methods especially when the risks are increasing in young children.