Objective: The aim of the present study was to evaluate the efficacy of extrathoracic jugulo-femoral venous shunt (JFVS) in avoiding the needfor cardiopulmonary bypass (CPB) during the bi-directional Glenn shunt (BDGS) procedure.Methods: A total of 40 patients aged between 9 and 36 months were enrolled in the present study. The patients were classified into two groups,group A (n=20) in which the patients had no veno-venous shunt and group B (n=20) in which the patients had extrathoracic JFVS. Patientsrequiring CPB, arterial oxygen saturation (SaO2), heart rate, mean arterial pressure (MAP) and central venous pressure (CVP) were recordedduring surgery. Postoperative time of intubation, intensive care unit (ICU) and hospital length of stays and neurological complications were alsorecorded.Results: The number of patients who needed urgent CPB was greater in group A than in group B. Intraoperative MAP was significantly lowerin group A than in group B 10 min after clamping of the superior vena cava (SVC) and 30 min after declamping of the SVC. The CVP wassignificantly lower, and arterial SaO2 was significantly higher in group B than in group A 10 min after clamping of the SVC. The duration ofpostoperative intubation was significantly shorter in group B than in group A, and the ICU length of stay was shorter in group B than in groupA. The hospital length of stay was similar in both groups. Postoperative neurological deficits were comparable in both groups.Conclusion: The use of extrathoracic JFVS during the BDGS procedure avoided the use of CPB, maintained MAP and prevented any significant increase in SVC pressure.