Abstract: AIM:To compare the effect of different surgical approaches for supracardiac total anomalous pulmonary venous connection (TAPVC). METHODS: Sixty patients with supracardiac TAPVC underwent surgical repair from August 2000 to April 2011, including 14 patients using the right atrium approach, 19 patients through right and left atrium incisions and 27 patients using the superior approach. RESULTS: Four patients (two with right atrium approach, one with right and left atrium incisions and one with superior approach) died after surgical repair. The main complications were pulmonary vein obstruction, low cardiac output, arrhythmia, acute pulmonary edema due to hypoplastic left heart, or respiratory failure. The complications in the superior approach group were significantly lower than those in the other two groups. CONCLUSION: Superior approach shows good short- and medium-term effect in the treatment of supracardiac TAPVC, but the long-term effect needs further follow-up.