<p>Complete surgical excision is the preferred treatment for selected cardiac fibromas, although reconstruction depends on tumor location and myocardial involvement. Cardiac fibromas are the second most common primary cardiac tumor in children. They most commonly arise from the ventricular free wall or interventricular septum. Several treatment strategies have been reported, including surgical resection, single-ventricle palliation, heart transplantation, and conservative management for primary benign cardiac tumors. Recent evidence suggests that surgical resection can be curative in selected patients, eliminating the long-term dependence on antiarrhythmic drugs and avoiding the necessity for implantable defibrillators. Although this approach is now considered standard practice in some institutions—even for extensive fibromas—its adoption remains limited. We report the case of a 2-year-old child with a giant cardiac fibroma treated with complete tumor excision using a combined endocardial patch and two-layered ventricular reconstruction. The early postoperative course was uneventful, with preserved ventricular function at short-term follow-up.</p>