OBJECTIVE: To evaluate the clinical value of a right subaxillary anterolateral minithoracotomy in open heart surgery in children with single congenital cardiac defects. METHODS: Twenty-five cases of children with congenital heart defects were operated through the right subaxillary anterolateral minithoracotomy, with 13 cases of the closure of atrial septal defect (ASD) and 12 cases of the ventricular septal defect (VSD). Accompanied abnormalities (2 cases with right ventricular outflow tract obstruction and 3 cases with partial anomalous pulmonary venous connection) were also corrected at the same time. RESULTS: All the patients were successfully operated. No operative mortality was noted. CONCLUSIONS: Except for complicated cardiac abnormalities, the right subaxillary anterolateral minithoracotomy is a safe and effective alternative to a median sternotomy for the correction of common cardiac defects.This approach is less invasive, produces small and hidden scars with optimal cosmetic appearance, and can avoid the postoperative pigeon breast.