Fast-track cardiac anesthesia (FTCA) is a perioperative management strategy, which includes early tracheal extubation, early mobilization, decreased length of intensive care unit (ICU) and hospital stay. It is well established that early extubation can improve the quality of patient recovery, reduce perioperative complications, and significantly decrease healthcare costs and improve resource utilization. However, the optimized fast-track anesthesia protocol still need to be further explored. Studies indicate that fast-track anesthesia is safe and effective, and can reduce the incidence of postoperative complications (intraoperative awareness, ventilator-associated pneumonia, delirium, nausea, vomiting and reintubation). The key to fast-track success is perioperative anesthetic management and early tracheal extubation that can facilitate patient recovery after surgery.