Smog is a relatively rare cerebrovascular disease that has two peak incidences, one in adults around the age of forty and the other in children under the age of ten. It would be very unfortunate for a child to develop smog. Patients with childhood smog usually show symptoms of cerebral ischemia, such as weakness of limbs, dizziness and headache, or seizures, etc. If left untreated, it can have adverse effects on the child’s brain development and physical growth, so timely treatment is needed. Traditionally, temporalis muscle patching is mostly used for the treatment of childhood smog. However, there are some limitations of this patching procedure, firstly, the patching factor is single and the effect of improving blood supply is limited; secondly, it takes 3-6 months to form neovascularization after the patching, and it is still very dangerous that the disease may develop during this period. What are the new advances in temporalis muscle patching for childhood smog? The medical community has been exploring and improving the surgical treatment of smog, and now there are more ideal and perfect treatment modalities. Combined vascular bypass surgery is a very advanced and ideal surgical modality to treat smog at present. Combined vascular bypass surgery is a compound surgery, direct bypass + multi-factor patching, to improve the blood supply to the brain more comprehensively. Direct bypass is generally to bring abundant blood flow from outside the cranium into the cranium, depending on the different parts of the brain involved, such as superficial temporal artery-middle cerebral artery bypass or occipital artery-posterior cerebral artery bypass, etc., which can quickly improve blood supply after completing the bypass; at the same time, patching is performed on the surface of the brain, and there are more patching factors, including temporal muscle patching, dural flip, cranial periosteal patching, vascular patching, etc., which can improve blood supply in a larger scope. The overall improvement of cerebral blood supply makes the operation more effective.