Abstract: AIM To discuss the perioperative application of intra-aortic balloon pump (IABP) in high-risk patients undergoing cardiac operations. METHODS From Jan. 2001 to Aug. 2002, 55 patients undergoing cardiac operation with application of IABP perioperatively were analyzed. RESULTS The total mortality was 42%, with 36.4% in coronary heart disease patients and 64% in non-coronary heart disease patients (P<0.05). In patients using IABP preoperatively, the mortality was much lower than that in patients using IABP during or postoperatively (0%, 40%, 50% respectively, P<0.05). After using IABP, homodynamic data improved and dose of cardiovascular drugs decreased significantly. CONCLUSION IABP is a safe and effective mode of circulation support. Prognosis depends on the heart conditions, proper indication, correct set-up and monitoring for IABP.