A 10-month-old female infant was diagnosed with a double aortic arch by cardiac ultrasound and CT scan. She was scheduled to undergo corrective surgery under general anesthesia. She had obvious wheeze after birth, with pulse oxygen saturation (SpO2) of 92%. Children with double arch often have tracheal stenosis and tracheomalacia due to vascular ring compression, so preoperative airway assessment, selection of appropriate tracheal tube, induction methods of anesthesia, and enhanced airway management during the perioperative period are important. In addition, invasive arterial blood pressure monitoring both in the upper and lower limbs should be established according to surgical needs.