Abstract: Neoadjuvant chemotherapy (NAC) refers to systemic chemotherapy administered before surgery or radiotherapy to reduce tumor size, kill cancer cells early, and facilitate subsequent treatments. However, NAC drugs can cause different degrees of damage to the heart, which mainly manifest as myocardial ischemia, arrhythmia, arterial hypertension, myocardial dysfunction, and even heart failure. NAC-induced cardiotoxicity has become an important risk factor in the perioperative period of cancer surgery, and it may affect surgical success and patient safety. Therefore, it is particularly important for anesthesiologists to perform relevant evaluations to actively prevent and treat patients with cancer having heart disease in the perioperative period. Therefore, we organized experts to formulate anesthesia management guidelines after NAC for patients with cancer having heart disease in China (2021 version). We also summarized clinical practice experience in terms of anesthesia selection and perioperative cardiac function protection to guide anesthesiologists in China.