Perioperative anesthesia management for children with congenital heart disease (CHD) requires multidisciplinary collaboration and precise understanding of anatomical anomalies and pathophysiological changes. This chapter outlines key perioperative strategies, including preoperative assessment (medical history, genetic background, comorbidities, physical examination, cardiopulmonary reserve, lab tests, imaging evaluation, and cardiac catheterization) and preparation for fasting, premedication optimization, and determinization of individualized anesthesia protocols tailored to shunt direction, obstruction severity, and mixing physiology. Intraoperative management integrates invasive blood pressure monitoring, transoesophageal echocardiography, cerebral oxygenation assessment, and temperature, while modulating pulmonary-to-systemic vascular resistance ratios and maintaining oxygen delivery-consumption balance. During cardiopulmonary bypass, prioritize perfusion pressure optimization and metabolic homeostasis. Postoperative care focuses on cardiopulmonary recovery, coagulation management, and multimodal analgesia, with early detection of complications. Complex CHD cases necessitate coordinated teamwork to optimize surgical-anesthesia-ICU transitions, improving outcomes.