Since 2009, we have been routinely performing small axillary cardiac surgery, mainly for atrioventricular defects with precordial disease, including some atrioventricular canal malformations, as well as mitral and tricuspid valve replacement and plication, and atrial mucinous tumors. More than 200 surgeries have been performed, with the youngest being 5 months old and the oldest 67 years old; the youngest weighing 6 kg and the oldest 85 kg, all with successful and satisfactory results. Compared with the traditional median incision, the advantages of the axillary incision are obvious: the incision is short and concealed, usually 2.8-5.0 cm in infants and children, and 6-7 cm in adults; the incision for mitral and tricuspid valve surgery is longer, usually 9.0-12 cm. The chest tube can be removed on the first day after surgery, shortening the length of hospital stay and avoiding blood transfusions in the majority of patients. Since the patient’s thoracic integrity is maintained, it facilitates postoperative recovery; since the axillary incision is not fixed with wires, no metallic material is left in the patient’s body, and there will be no foreign body impervious to X-rays during future medical examinations, and privacy is better; for infants and young children, it avoids the appearance of a chicken chest after the median incision fixes the sternum. Most doctors in China use the fourth intercostal approach to the chest, while we use the third intercostal approach, so that the incision is closer to the axilla and more private, and the third intercostal approach is more convenient to deal with the aorta, although it seems difficult to deal with the inferior vena cava, but it is not difficult to insert the tube after the parallel circulation and the right atrial void. In the early years we used to use an anterolateral chest incision for cardiac surgery, which for some girls may cause effects on breast development, whereas the axillary incision principle breast would not have this concern.