A 7-year-old boy presented with abdominal distension for 1 year, accompanied by chest tightness after activity, inability to lie down at night, morning eyelid edema, etc. Cardiac ultrasound and digital subtraction angiography (DSA) examinations suggested increased pressure in the inferior vena cava, right atrium, right ventricle, etc. Based on clinical manifestations, constrictive pericarditis was suspected, and pericardiectomy was planned under general anesthesia. In cases such as this, anesthesia should focus on a thorough preoperative assessment and the implementation of appropriate management strategies before and after pericardial stripping surgery. During the operation, selecting suitable invasive monitoring and effective vascular access is important, as well as administering appropriate vasoactive drugs and fluid therapy based on the monitoring indicators to maintain circulatory function stability after pericardial stripping and prevent circulatory collapse. For children undergoing surgery for constrictive pericarditis, the entire medical team needs to focus on the cause of the disease, clearly communicate the surgical steps, and establish good medical connections.