A one-month-old male infant was admitted to our hospital due to dyspnea and difficulty breathing. Echocardiography indicated aortopulmonary window, atrial septal defect (Type II), moderate tricuspid regurgitation, pulmonary valve regurgitation, and mild to severe pulmonary hypertension (100 mm Hg). Chest radiograph suggested bilateral pulmonary infiltrates. He was diagnosed with an aortopulmonary window complicated with severe pneumonia. After admission, active anti-infection and optimization of cardiac function were conducted. After the infection was controlled, the aortopulmonary window radical surgery was performed under general anesthesia. Anesthetic management should focus on preventing infection while optimizing ventilation management, rational use of positive inotropic agents, and maintaining the balance of systemic and pulmonary circulation.