Background　Anterior mediastinal mass makes great challenges to the anesthesiologist due to their significant impacts on the circulation and respiration.　Objective　To provide reference for making adequate perioperative anaesthetic management of anterior mediastinal mass and the subsequent research.　Content　This review restrospectively analyzes perioperative anaesthetic management of anterior mediastinal mass in relevant articles and case reports.　Trend　Patients, stratification of mediastinal mass regarding safety for general anesthesia is "unsafe", should avoid general anesthesia as far as possible. When general anesthesia can not be avoided, full evaluation and preparation should be taken, and having their femoral vessels cannulated in readiness for cardiopulmonary bypass is necessary. General anesthesia should be induced mildly in the proper position maintaining autonomous breathing. Muscle relaxants can be used until the patient is intubated smoothly and confirmed. If faced with sudden difficult ventilation or failed in bronchoscopy guided reintubation, emergent cardiopulmonary bypass should be eatablished. Fully assessment of the airway should be done before decannulation.