Abstract： Objective To review the current outcomes of bidirectional Glenn (BDG)shunt in the treatment of children with complicated cyanotic congenital heart disease.Methods A total of 103 consecutive patients in high-risk Fontan procedure underwent Glenn shunt at our center from May 2008 to December 2012.The diagnoses included single ventricle (n = 61 ),transposition of great arteries (TGA,n= 12),corrected transposition of great arteries (c-TGA,n = 1 5 ),double outlet of right ventricle (DORV,n = 5 ),Ebstein anomaly (n =4),pulmonary atresia with intact ventricular septum (PA/VSD,n = 2 )and right ventricular hypoplasia (n = 4 ).There were 1 7 patients with heterotaxy syndrome. A total of 83 patients underwent unilateral operations and the remainder bilaterally.Among them,the procedure was performed with cardiopulmonary bypass (CPB)(n=50) and without (n = 56).Concomitant procedures included pulmonary artery reconstruction (n = 1 8 ), atrial septectomy (n = 1 5 ), pulmonary artery banding (n = 12 ), correction of total anomalous pulmonary venous connection (TAPVC, n = 6 ), atrioventricular valve repair (n = 6 ) and atrioventricular valve replacement (n = 2).Results Two early operative mortalities occurred with a rate of 1 .9%.The mean pulmonary artery pressure was 16.74 ± 2.95 mmHg. And the mean systematic oxygen saturation increased from 68 ± 13% to 84±6% at discharge.The mean follow-up period was 1 .5±1 .2 (0.5-3)years.During the observational period,1 patient died.The procedures included Glenn takedown plus B-T shunt (n = 1 )and atrioventricular valve replacement (n = 2 ). Twenty-six patients,considered optimal candidates,underwent Fontan operation.The remainders were well-palliated with an arterial oxygen saturation of 80±1 1 % at rest,cardiac function (NYHA) I-II class and no anastomotic stenosis.Conclusions Glenn shunt is an excellent temporary palliation prior to a Fontan operation for various cyanotic CHDs leading eventually to a single ventricle repair.It is of great importance for preventing an elevation of pulmonary arterial pressure and improving patient outcomes.