A patient with intravascular hemolysis due to residual shunt and right ventricular outflow track obstruction after total correction of TOF was presented. The patient was 29 years old female. She underwented VSD closure with dacron patch, infundibulectomy, pulmonic valvotomy and direct closure of PFO. 8 months after the operation, severe intravascular hemolysis and hemolytic anemia appeared. Conservative therapies were not effective, her general condition and laboratory finding got worse gradually. She underwent reoperation, the shunt was closed and right ventricular outflow tract obstruction was corrected by pulmonary valvotomy, infudibulectomy and transannular patch. After operation, hemolysis disappeared dramatically. Severe hemolysis may induce renal failure and necessitate transfusion frequently. If hemolytic anemia is not corrected by conservative treatment, early reoperation is required.