Left subclavian artery-left coronary artery end-to-end anastomosis was successfully performed on a six-month-old female infant with anomalous origin of the left coronary artery from the pulmonary artery and severe mitral regurgitation. A piece of pulmonary arterial wall including the opening of the anomalous left coronary artery (ALCA) was isolated and was used for anastomosis instead of utilizing the left coronary arterial wall itself. Her postoperative course was uneventful and mitral regurgitation disappeared 6 months after surgery. This improved technique seems to be applicable for this anomaly, regardless of the age of patient or size of the left coronary artery.