Objectives: Post-cardiac surgery mediastinitis is a serious complication with high morbidity and high financial costs. Using a vacuum-assisted closure system is the established line of treatment for mediastinitis, which improves outcome, especially in the high-risk group of patients. Methods: From January 2007 to April 2011, a retrospective study was carried out to evaluate the outcome of vacuum- assisted closure in the treatment of postoperative mediastinitis. Results: There were 34 patients; 27 were male and 7 female. Mean time from infection to vacuum-assisted closure was 3.34 Æ 1.10 days. The duration of vacuum-assisted closure was 6.51 Æ 1.85 days (3-9 days). The mean amount of dis- charge was 759.60 Æ 175.28 mL (range, 354-990 mL). Of the 34 patients, 21 (61.76%) had direct surgical wound closure and 13 (41.16%) had re-wiring. Two patients had bilateral pectoral flaps. One patient had chronic fistula formation, and one had a tear in the right ventricle. Mean hospital stay was 11.28 Æ 2.09 days (range, 6-16 days). Conclusion: Vacuum-assisted closure therapy is a safe, reliable, and cost-effective modality of treatment for post- operative mediastinitis. It improves the outcome and can be combined with other modalities of conventional treatment, especially in high-risk groups such as the elderly or patients with diabetes.