A one-year-old girl was found to have heart murmurs during a physical examination. Echocardiography showed coarctation of the aorta (CoA). She was scheduled to undergo an end-to-end anastomosis of the aorta under general anesthesia without cardiopulmonary bypass support. During the operation, controlled hypothermia, hypotension, and aortic cross-clamping were conducted to remove the narrowed segment and perform an end-to-end anastomosis to reconstruct the vascular structure. The blood pressure differences between the upper and lower limbs were significantly reduced, and the hemodynamics became stable after the circulation was resumed. After the operation, the patient was safely transferred to the Cardiac Intensive Care Unit (CICU). CoA may be relieved by resection and end-to-end anastomosis without cardiopulmonary bypass. The key point of anesthetic management is maintaining hemodynamic stability and protecting organ function.