A 2-month-old infant was diagnosed with multiple ventricular septal defects upon an echocardiographic evaluation after birth. Subsequently, symptoms of difficulty in feeding, shortness of breath, etc. gradually deteriorated. To protect the normal development of pulmonary vascular beds and alleviate the symptoms of congestive heart failure, pulmonary artery banding (PAB) surgery was proposed. The key points of anesthetic management for PAB are to control heart failure before surgery, choose the best time of operation, avoid the increase of left-to-right shunt due to excessive ventilation before banding, and stay alert to acute right heart failure caused by increased right ventricular afterload after banding.