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Purpose The aim of our study was to investigate hemodynamic and functional outcome after pulmonary endarterectomy (PEA) in patients with symptomatic chronic thromboembolic pulmonary disease (CTED). Methods The study included 48 consecutive CTED patients who underwent PEA from February 2001 to April 2018. In all patients a clinic, functional and hemodynamic evaluation was performed before PEA. Hemodynamic changes and functional capacity were recorded at 3 months and one year after PEA. Results At every time-points after PEA patients had significantly lower values of mean pulmonary artery pressure (mPAP) (p=0.001) and pulmonary vascular resistance (PVR) (p<0.001), higher arterial pressure of oxygen values (p=0.002) and a significantly better functional capacity at both 6mWT (p=0.029) and modified Bruce test (p<0.001) as compared to pre-operative data. At one year after PEA a significant change of WHO functional class was detected in all patients (p<0.001) and every CTED patients were in I or II WHO functional class. The hospital mortality is low (one patient of 48, 2.1%) with an optimal survival at 5 years (97%). Conclusion In our opinion, the PEA is the gold standard treatment in symptomatic CTED patients. The improvement of hemodynamic and functional outcome at every time-points after surgery and the low mortality shows the efficacy and the safety of this treatment. [ABSTRACT FROM AUTHOR]