Abstract: AIM To analyze the results of the surgical treatment in 167 cases of adult congenital heart disease (ACHD) with complex malformation. METHODS A total of 167 surgically treated patients with adult congenital heart disease (ACHD) with complex malformation from January 2012 to February 2015 in Fuwai Hospital were included in this study. Clinical data, type of ACHD, surgical technique, and preoperative results of these patients were collected and analyzed. RESULTS Of the 167 cases, 135 underwent correction operation, 30 underwent palliative operation and two underwent two pericardial fenestration procedures. Tetralogy of Fallot (TOF) had the highest incidence (20.3%) followed by partial anomalous pulmonary venous connection (PAPVC) (13.8%) and complete type endocardial cushion defect (TECD) (10.8%). After operation, two patients died with a mortality rate of 1.19%. Thirty-six patients had postoperative complications with an incidence of 21.6%. The average mechanical ventilation time was( 26±13) h and the average ICU time was (3.2±1.6) day. CONCLUSION Adult congenital heart disease has a long personal disease history, which results in obvious pathological and physiological changes. If ACHD is treated with proper surgical technique, satisfactory results can be achieved.