Here we report a case of a previously unoperated 35-year-old male TOF patient. He was admitted due to dyspnea, initial physical examination demonstrated cyanosis and heart murmurs. Echocardiography suggested secundum atrial septal defect, perimembranous ventricular septal defect and mild-severe aortic regurgitation. Computed tomography angiography indicated aortic root dilation and suspicious right coronary artery aneurysm. Concurrent repair of TOF and VSARR was performed successfully and the patient had a satisfactory recovery.