Objective ·To analyze the neurodevelopmental outcomes of children after end-to-side anastomosis for coarctation of the aorta (CoA). Methods ·The surgical and neurological follow-up data were collected from children who underwent end-to-side anastomosis for CoA at Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine from January 1, 2017 to December 31, 2021. Neurological assessments included magnetic resonance imaging (MRI) and Griffiths Mental Development Scale assessments. Neurodevelopmental outcomes were evaluated using Griffiths Mental Development Scale. Clinical characteristics were compared between patients with normal and abnormal MRI and Griffiths Mental Development Scale results to assess the correlation between the two assessments and their association with cardiopulmonary bypass (CPB) use and CPB modality. Results ·Twenty-seven children with isolated CoA or CoA combined with simple intracardiac anomalies were included. MRI results were available for 25 cases, with 5 showing abnormalities (20.0%). Griffiths Mental Development Scale results were available for 26 cases, with 21 (80.77%) showing abnormal scores, including 18 in hearing and language, and 12 in performance. No significant correlation was found between abnormal MRI or Griffiths Mental Development Scale results and the use of CPB (P=0.341, P=1.000). Among patients who underwent CPB, those in the moderate hypothermia group accounted for the majority of cases without neurological abnormalities, with proportions of 80.00% (MRI) and 100.00% (Griffiths Mental Development Scale). Conclusion ·Children undergone end-to-side anastomosis for CoA are at relatively high risk for neurodevelopmental abnormalities, particularly in hearing-language and performance domains. CPB may not be a direct risk factor for poor neurodevelopmental outcome, and moderate hypothermia during CPB may be neuroprotective.