Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart disease after 1 year of age. Less than 5% of all patients with uncorrected ToF live beyond the age of 40 years. Prognosis after surgical correction is good with a 32-year survival of 86% of the cases. Predictors of long-term mortality include older age at operation and postoperative right-to-left ventricular peak systolic pressure ratio of 0.5 or higher [1]. Surgery is performed to close ventricular septal defect (VSD) and relieve right ventricular outflow tract obstruction(RVOTO). Adult patients with surgical repair of tetralogy of Fallot in history often develop complications, which include severe pulmonary regurgitation, RVOTO, right ventricular dilation and dysfunction, residual VSD, aortic root dilation with aortic regurgitation, left ventricular dysfunction, endocarditis, atrial and ventricular tachycardia, and sudden cardiac death. We present a case of a female patient with several long-term complications after ToF repair. JRCD 2014, 1 (7): 24–28