Objective To analyze the causes of death after modified Blalock-Taussig shunts in children with congenital heart diseases, and explore the nursing strategies. Methods On the basis of literature review and expert consultation, the clinical data of 94 children with congenital heart diseases undergoing modified BlalockTaussig shunts were retrospectively analyzed, and univariate analysis and Logistic regression analysis were employed to explore the risk factors for death during perioperation. Results Eighteen of the 94 children died after operation, with the motality of 19.1%. Univariate analysis revealed that age, weight, height, the artificial blood vessel diameter, preoperative acidosis, delayed sternal closure and reoperation were death-related risk factors. Logistic regression analysis indicated that preoperative acidosis was the independent death-related risk factor. Conclusion Enhancing preoperative assessment of risk factors, preventing preoperative acidosis, conducting postoperative care, preventing stenosis and obstruction of the artificial blood vessel, performing perioperative nutritional supporting and strengthening perioperative care of newborn are the main care countermeasures to decrease the motality after modified Blalock-Taussig shunts in children with congenital heart diseases.