A 2-year-old boy was diagnosed with perimembranous ventricular septal defect (VSD) by cardiac ultrasound and scheduled for transcatheter closure of VSD (nonsurgical) under general anesthesia. He had an upper respiratory tract infection (URI) with symptoms of fever, sneezing, runny nose, and coughing 1 week ago. Recent URIs can significantly increase the risk of perioperative respiratory adverse events (PRAE) and put a great challenge on anesthetic management during the perioperative period. The anesthetic management for children with recent URI should focus on the prevention and treatment of PRAE, including preoperative intranasal dexmedetomidine or/and aerosolized budesonide inhalation to reduce airway hyperreactivity, using laryngeal mask airway instead of endotracheal intubation as much as possible, endotracheal extubation under deep anesthesia.