To summarize the perioperative nursing care of a premature infant with type Ⅲb esophageal atresia and pulmonary hypertension treated with thoracoscopic assistance. The key points of the perioperative nursing care were as follows：maintaining a patent airway，maintaining stable cardiac function，avoiding hypoxemia before the surgery；strengthening airway management，developing an deoxygenation training plan，preventing anastomotic fistula，maintaining systemic blood pressure，paying attention to enteral and parenteral nutritional support after the surgery；implementing family-empowerment nursing to enhance the caregiver’s ability after discharge. After active treatment and meticulous nursing care，the infant’s condition stabilized and she was discharged in good health. The follow-up results were satisfactory.