This case report describes the management of a 71-year-old man who suffered from hyperplasia of prostate gland and developed perioperative myocardial infarction(PMI) after transurethral prostatectomy（TURP）. Perioperative hypotension, anemia, hypoxemia, and hypothermia aggravated the patient’s ischemia and volume overload, leading to ventricular fibrillation and PMI. After the management by defibrillation, cardiotonic agents and circulation supports, the patient was getting better and recovered to a stable condition. PMI is a major cause of morbidity and mortality in patients undergoing noncardiac surgery, so more attention should be paid to its diagnosis and management.