Advancements in medical management have improved the survival rate of pediatric heart transplant recipients. However, social reintegration among these patients remains unclear. This retrospective study examined 61 patients who underwent heart transplantation under 18 years of age between 2000 and 2019. The cohort consisted of 29 males and 32 females, with a median age at transplantation of 7 years (interquartile range [IQR], 2–13). The median follow-up duration was 10 years (IQR, 7–15.5). 5-year, 10-year, and 15-year survival rates were 91%, 91%, and 83%, respectively. Excluding three patients who died before reaching school age, stable school attendance was achieved in 56 of 58 patients (97%). Among the 38 patients aged 18 years or older, 15 (39%) were employed, 13 (34%) were enrolled in higher education, and 10 (26%) were neither employed nor enrolled in education. Univariate analysis revealed that neurological disorders significantly hindered educational and occupational outcomes (P = 0.002). While compulsory educational outcomes were favorable among pediatric heart transplant recipients, 26% of patients above age 18 were neither employed nor enrolled in education. Neurological complications emerged as a key risk factor for social outcomes.