A 12-year-old boy presented with a 4-year history of unexplained hypertension accompanied by chest tightness and other complaints. After careful examination by vascular ultrasound, cardiac ultrasound, and cardiac MRI, he was diagnosed with aortitis and descending aortic stenosis. He was scheduled to undergo bypass surgery with general anesthesia. During the operation, the abdominal aorta was found to be significantly narrowed at the diaphragm, and the vessel wall was stiff. The artificial blood vessel was anastomosed to the abdominal aorta and the ascending aorta along their right-sided walls, respectively. In such cases, the key point of anesthetic management is to maintain blood pressure at an appropriate preoperative level, adequate perfusion pressure without drastic changes in cardiac preload and afterload, and avoid further supersession of the function of cardiac and cerebral vessels by drugs. Other severe potential accidents should also be avoided and treated immediately. To better support bypass surgery in children with multiple large arteritis, the anesthesiologist team members should fully understand the abnormal anatomic structure, the disease’s stage and pathophysiology, and the functions of vital organs.