In this chapter the essential aspects of anesthesia for repair of tetralogy of Fallot (TOF) are reviewed. Subtopics include hemodynamic considerations in TOF patients such as right ventricular hypertrophy, components of TOF, and circulation in the TOF patient. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Issues discussed that are related to preoperative evaluation include differentiating between cyanotic and acyanotic cardiac lesions, recognizing Tet spells and systemic vascular resistance, and use of antibiotic prophylaxis. Intraoperative topics include induction, onset time of anesthetic agents, and blood therapy. Postoperative care addressed includes extubation, hypothermia, and hypoxia.