Background: ABO incompatible heart transplant is a method to increase the infant donor pool. There remains limited data on long term survival and rejection after ABO incompatible heart transplant in recent era. Methods: United Network for Organ Sharing (UNOS) database was queried for infant heart transplants performed from January 2008 to March 2020. Patient demographics and known risk factors for post- transplant mortality were collected. Statistical analysis using Bayesian Additive Regression Trees (BART) was performed to evaluate the association of ABO incompatibility and overall survival, graft survival, acute rejection episodes and length of stay. Results: A total of 1,368 infants (age<1 year) were included, of which 280 (20.47%) were ABO incompatible. ABO incompatibility was not associated with increased all-cause mortality, acute rejection episodes or length of stay. Whereas ECMO and intubation status of the recipient at the time of transplantation were associated with increased all-cause mortality and graft failure. Idiopathic cardiomyopathy was associated with a decreased likelihood of post-transplant all-cause mortality. One-, 5- and 10-year survival among compatible vs. incompatible transplants was estimated to be 90% vs. 88%, 82% vs. 79% and 77% vs. 73%, respectively. Conclusions: ABO incompatible infant heart transplant does not affect post-transplant survival, incidence of rejection, or postoperative length of stay. Therefore, it remains a viable and important strategy to increase the infant donor pool.