Infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus with reduced vancomycin susceptibility (SARV) has been reported worldwide. We report the successful treatment of a pediatric patient with SARV IE and characterization of the infecting strain. The MIC of vancomycin rose from 1.5 to 2 mu g/ml, and the SARV was confirmed by population analysis.