We reviewed all specimens in the archive with the phenotypical features of tetralogy of Fallot, specifically anterocephalad deviation of the outlet septum with abnormal septoparietal trabeculations producing subpulmonary infundibular obstruction in the setting of a ventricular septal defect and aortic override. Specimens with pulmonary atresia or so-called ‘absent’ pulmonary valve were excluded. All hearts included had usual atrial arrangement and concordant atrioventricular connections. The ventriculo-arterial connections showed a spectrum between concordant and double-outlet variants depending on the extent of aortic override, but all specimens were confirmed to have aortomitral fibrous continuity. Specimens were classified as unrepaired or operated. An unrepaired heart was defined as one in which no surgical operation had been performed on the myocardium during life; hearts from patients who had undergone only a palliative extracardiac shunt were thereby classified as unrepaired.