In this retrospective study, the authors analyzed outcomes in 245 patients with left-sided infective endocarditis (IE) and noninfected cardiac implantable electronic devices (CIEDs) who underwent cardiac surgery, using data from the CAMPAIGN Registry, which included 4,917 patients operated on between 1994 and 2018. Two groups were compared: those who underwent CIED extraction (100 patients, 40.8 percent) and those who did not (145 patients, 59.1 percent). After propensity score matching, 74 pairs were analyzed, revealing the 30-day mortality was 13.5 percent in the extraction group vs 20.3 percent in the nonextraction group (p=0.23). Patients who underwent device extraction had significantly longer ICU stays (median of 8 vs. 4 days; p=0.003) and hospital stays (median of 24 vs. 17 days; p<0.001). Estimated eight-year survival was similar between groups, with 31.5 percent for the extraction group and 28.6 percent for the nonextraction group (subdistribution hazard ratio 0.8; 95 percent CI 0.5–1.2; p=0.26). Recurrent IE rates were also comparable, with six-month rates of 3.5 percent extraction vs. 4.7 percent for nonextraction, and eight-year rates of 5.4 percent vs. 11.3 percent (subdistribution hazard ratio 0.43; 95 percent CI 0.1–1.7; p=0.24). Overall, CIED extraction in these patients did not lead to improved survival or lower rates of IE recurrence, though it was associated with longer ICU and hospital stays.