Introduction: Heart transplantation is an effective solution to end-stage heart failure. Appropriate nutritional support improves not only the nutritional status but also the success rate and recovery from transplantation. We reported the peri-operative nutrition management of a heart-transplant child. Case presentation: The child is a 4 years and 10 months’ old boy diagnosed with dilated cardiomyopathy . His cardiac function was progressively deteriorating with lower-limb oedema and feeding refusal. Therefore, the child received heart transplantation, undergoing delayed sternal closure, ECMO support, mechanical ventilation, anti-infective, and immunosuppression therapy . The nutrition team was involved throughout the hospitalization. The child was 104 cm (P10) in height and 14.3kg (P8) in weight at admission, having lost 14.8% weight in 1 month. He received parenteral nutrition (PN) pre-transplantation because ofinsufficient oral intake. On post-operative day (POD) 1, the child received continuous nasogastric feeding with hydrolysed, high-calorie formula and shifted to intermittent feeding. On POD 21, the child transited to oral feeding. However, on POD 26, the child developed chyloperitoneum (8-15 ml/kg/day). Enteral nutrition (EN) was shifted to a fat-free formula, On POD 30, drainage fluid increased to 20 ml/kg/day and PN was added. We changed to high-MCT formula for EN after drainage fluid decreased. On POD 36, his total intake achieved 106 kcal/kg/ day (3.5g/kg/day protein, 80 kcal/kg/day and 2 g/kg/day protein from EN) and PN was discontinued. The drainage tube was removed on POD 43. The child was discharged on POD 48. Conclusion: Full-course nutrition support tailored by peri-operative stages is necessary to heart-transplant children.