The planned Australian National Cardiac Surgery Database is likely to have a number of positive outcomes, including increased patient satisfaction, improved quality assurance and increased economic efficiency. In relation to cardiac surgery, performance indicators associated with the commonly performed procedure of coronary artery bypass surgery will be used for peer review and to measure outcomes. Several different risk-adjusted models are available for analysing national databases. However, the potential weaknesses of database analysis are lack of both compliance and data validity. A number of other major issues, such as location of the data analysis centre, who will hold authority over data accuracy, and the security of and access to the Database, must also be considered when setting up the National Database. Overall, however, the benefits of a national database will be enormous. Cardiologists and cardiac surgeons will benefit from a disease-based registry with shared common definitions. In addition, the provision of such a database will represent a crucial step towards developing national strategies for treating heart disease.