Objective To summarize the clinical experience of medical-surgical mosaic treatment of complex cyanotic congenital heart disease with combined body-pulmonary collateral, and to discuss its therapeutic significance, operation technique and safety. Methods A retrospective analysis of 41 patients with complex cyanotic congenital heart disease combined with body-pulmonary collateral branches, aged 1 to 28 years (15.1±9.8), weighing 18.2±7.8 kg. spiral CT examination was performed to confirm the diagnosis. 38 cases had preoperative blocking of collateral vessels, and 3 cases had preoperative blocking of collateral vessels after the operation was missed. The whole group underwent surgical one-stage orthopedic surgery. Results The whole group was cured in 37 cases. There were 4 deaths: 1 case died of pulmonary infection and 3 cases died of intractable heart failure. The diameter of the collateral vessels ranged from 2.5 to 9.4 mm (5.3±2.1). Three patients were placed with 3 to 21 spring coils each, with a mean of 10.2. Three cases were blocked twice postoperatively due to recanalization of the collateral vessels. Postoperatively, 14 cases were complicated by pulmonary infection, 3 cases of pulmonary edema, and 2 cases of perfused lung. Conclusion Complex cyanotic preconditioning with combined somatic pulmonary collaterals should have combined medical and surgical management of collateral vessels in the perioperative period. Percutaneous interventional occlusion can be used, which is effective, simple, safe, feasible with multiple branches and multiple occlusion, effectively reducing the occurrence of complications and decreasing operative mortality.