This report is concerned with our clinical experience of 40 cases of anesthesia for open heart surgery at the Department of Anesthesiology, Seoul Adventist hospital during the period between July, 1988 and May, 1990. The results were as follows: 1) Among the 40 cases, 16 cases were congenital heart disease and 24 cases were acguired heart disease. 13 cases were male and 27 were female, Age was varied from 4 years to 71 years and mean was 33.2 years. 2) Morphine and glycopyrrolate were used as premedicants. 3) Thiopental, morphine and fentanly were used as induction agents, were injected singly or in combination. 4) Morphine, fentanyl and N2O were used as anesthetic agents in conjunction with halothane or enflurane. 5) Succinylcholine, vecuronium and pancuronium were used for intubation and maintenance of muscle relaxation. 6) The duration of eardiopulmonary bypass, aortic cross clamp, surgery and anesthesia in acquired heart disease were longer than in congenital heart disease, 7) Overall the mortality rate was 5% and the cause of death were air embolism and respiratory failue.