Aim . To study the five-year experience of using a modified subclavian-pulmonary anastomosis according to BlelokTaussig in the surgical treatment of complex congenital heart disease in patients with univentricular hemodynamics and depleted pulmonary blood flow. Material and methods . From 2012 to 2020, 32 children with complex CHD, with duct-dependent blood flow, underwent operations to impose a modified subclavian-pulmonary Blelock-Taussig anastomosis (MBTA). The average age of the children was 13±6.7 months, and the average weight was 8.8± 5.2 kg. Results and discussion . Fatal outcome in the early postoperative period was observed in 3.13% of cases. Bleeding in the early postoperative period was observed in 6.25% of patients. In 28.1% of patients with Fallo’s tetrada thereafter radical correction of the defect was performed. Bidirectional cavopulmonary anastomosis was performed in 40.6% of patients with a single ventricle. Postoperative follow-up results were studied in 96.8% of patients. Conclusion . The use of a modified left subclavian-pulmonary anastomosis according to Blalock-Taussig is the optimal palliative procedure in children with depleted pulmonary blood flow. This surgery is performed to prepare the patient for subsequent correction of a complex heart defect and allows the right pulmonary artery to be preserved intact for future use during radical or hemodynamic correction of the defect.