Ventricular septal defect is the most common congenital heart disease. It refers to the embryonic underdevelopment of the ventricular septum, which forms abnormal traffic and produces left-to-right shunts at the ventricular level; it can exist alone or be part of some complex cardiac malformation. Principles of surgical treatment (1) Given the possibility of natural closure of ventricular defects, children with small defects and young age can be observed until 2-3 years of age. (2) Very small ventricular defect, asymptomatic, chest X-ray and ECG are normal, generally do not need surgical treatment. However, regular outpatient follow-up should be performed. (3) For children with ventricular defect without the possibility of self-healing and without pulmonary hypertension, elective surgery can be performed at the age of 1~4 years. (4) Sub-stem defects should be radically treated before 2 years of age to prevent the occurrence of aortic valve prolapse. (5) Some large ventricular defects, recurrent pneumonia, heart failure, unsatisfactory control by active medical treatment, regardless of age and weight, should be treated by early surgery. (6) Children with severe resistance-type pulmonary hypertension and clinical cyanosis should be contraindicated for surgery. (7) Regular postoperative follow-up should be performed to pay attention to the presence or absence of residual shunts and recovery of cardiac function. Depending on the location of the defect, different surgical incisions (median, right, or small) can be chosen. Interventional occlusion is not recommended for ventricular septal defects, because it is not uncommon to report atrioventricular block and the need for permanent pacemakers in the distant future.