A standardized approach to the patient with single ventricle anatomy (SVA) is presented in this article. Regardless of the specific anatomic subtype, patients with SVA share common risk factors for early and late mortality and morbidity. Management of the SVA patients requires a plan to avoid development of these risk factors. Neonatal palliation is directed at relieving any systemic obstruction and appropriate limitation of pulmonary blood flow. The application of a standardized approach to the neonate with SVA, followed by staged palliation to a completion Fontan procedure should result in improved early and late outcome.