This chapter explores “Goal-Directed Perfusion (GDP)” during cardiac surgery’s CPB stages. The primary objective of CPB is to ensure adequate blood flow, perfusion, and oxygenation to all tissues and organs. This necessitates maintaining sufficient oxygen delivery, characterized by the product of systemic blood flow and arterial oxygen content, alongside adequate mean arterial pressure. The chapter builds upon concepts discussed in Chap. 14 , “Monitoring Adequacy of Perfusion during CPB.” It expands on vital goals beyond basic oxygen delivery, including preventing venous hypertension and cardiac distension, minimizing both micro and macro-embolism, reducing inflammatory and stress responses, limiting coagulation activation, minimizing myocardial ischemia, reducing the return of unprocessed cardiotomy drainage, and optimizing surgical exposure. The chapter provides a comprehensive guide on the critical aspects that require attention during different phases of CPB to ensure GDP. It emphasizes the importance of a tailored approach, adjusting perfusion parameters based on individual patient needs and surgical stages. This chapter serves as a vital resource for perfusionists and cardiac surgery teams, aiming to optimize perfusion strategies throughout CPB.