Background: Uncommon events in cardiac surgery may increase morbidity and mortality. We present an institutional experience of management of unusual events related to coronary artery in pediatric cardiac surgery to expand knowledge about them aiming to avoid related unexpected complications. Patients and methods: Among 837 pediatric cardiac surgery cases, we recorded six cases who presented with unusual anomalies and complications related to coronary arteries between May 2017 and June 2019. Pre-operative echo-cardiography was the standard investigation for all cases and other specific work-ups were ordered according to each case. Management by surgical or non-surgical intervention was planned according to each unusual anomaly or complication. Post-operative hemodynamics and mortality rate were the main determinants of the outcome. Results: Unusual scenarios related to coronary artery recorded 0.71% among all cardiac operations in children. Early management of complicated coronary artery after arterial switch operation was the common procedure. Post-operative extracorporeal membrane oxygenator was indicated for 3 cases. One death was recorded. Conclusion: Early management of unusual series related to coronary artery during cardiac surgery could lower risk and achieve favorable outcome.