Objective To summarize the clinical experiences of surgical treatment of tetralogy of Fallot (TOF) in infants, and to evaluate its short- and mid-term efficacy. Methods The clinical data of 142 infants with TOF preoperatively diagnosed by cardiac color Doppler ultrasound and/or cardiac CT angiography were retrospectively reviewed. There were 79 males and 63 females with a mean age of (6.4±2.7) months (range 1-12 months) and a mean body weight of (6.7±1.4) kg (range 3.0-12.0 kg). The mean McGoon index was 1.59±0.34 (range 0.80-2.47), and the left ventricular end diastolic volume index was 25.5±5.9 (range 14.0-36.3). One-stage radical operation was performed in 138 cases under moderate hypothermic cardiopulmonary bypass, and staging radical operation was performed in 4 cases. Results The mean time of cardiopulmonary bypass, arrest of the ascending aorta, post-operative ventilation, and ICU stay were (95.0±21.7) min, (54.3±15.1) min, (40.2±30.5) h, and (5.0±3.5) d, respectively. Two cases died in the early postoperative period, with the mortality being 1.4%. Reoperation in the early postoperative period was performed in 4 cases (2.8%). The incidence rate of postoperative complications was 7.0% (10/142), including low cardiac output syndrome, pulmonary infection, acute renal failure and so on. Medium term clinical follow-up was achieved in 127 (89.4%) cases. The mean follow-up time ranged from 11 to 62 months (median 37 months). There was no death or reoperation during the follow-up period. The cardiac function NYHA classⅠwas found in 117 cases, and class Ⅱ in 10 cases. During the follow-up period, all patients had normal right ventricular ejection fraction, and various degrees of pulmonary regurgitation (PR), including trace or mild PR in 113 cases (89.0%) and moderate PR in 14 cases (11.0%). Conclusion Radical operation of TOF in infants is safe and effective, with satisfactory short- and medium-term outcomes. Optimizing operation method and strengthening the perioperative management are the keys to improve the successful rate of operation in TOF infants, with satisfactory early- and mid-term curative effect.