Background　In pediatric patients, near-infrared spectrophotometry (NIRS) can detect regional oxygen saturation (RSO2) in multiple organs, which offers non-invasive, real-time, continuous monitoring.　Objective　To review the application of NIRS in the peri-operative period of pediatric cardiac surgery, and to provide guidance for the practice of clinical anesthesia.　Content　The alterations in RSO2 detected with NIRS represent the changes in oxygen supply and consumption of tissues, and can be used to evaluate metabolic status of multiple organs. NIRS is commonly used for surveillance of RSO2 and reperfusion in the brain during cardiovascular surgery and neurosurgery, and for prediction of patients′ prognosis, as well.　Trend　NIRS is a promising technique for perioperative monitoring of RSO2 in multiple organs of pediatric patients undergoing cardiac surgery, while large, randomized, and prospective studies are needed to validate its clinical use.