Objectives: We aimed to compare the short- and mid-term results of perfusion strategies used for arch reconstruction surgery. Material and Methods: One hundred and seventy-three consecutive patients who underwent aortic arch reconstruction surgery for transverse arcus hypoplasia between January 2011 and February 2020 were retrospectively analyzed. The patients were divided into two groups, as beating heart group and cardiac arrest group. Results: The cardiac arrest group comprised 60 (35%) patients and the remaining 113 (65%) patients were in the beating heart group. The median age of the patients was 30 (IQR 18–95) days. The incidences of acute renal failure and delayed sternal closure were higher in the cardiac arrest group (P = 0.05,P < 0.001 respectively). Balloon angioplasty was performed in 5 (2%) patients and reoperation was performed in 11 (6%) patients due to restenosis. There were no statistically significant differences between the two groups in terms of reoperation or reintervention rates (P = 0.44 and 0.34, respectively). Conclusions: Both strategies were associated with satisfactory mid-term prevention of reintervention and reoperation. Given the lower incidence of acute renal failure and delayed sternal closure in the postoperative period and similar mid-term outcomes, we believe that the beating heart strategy is preferable.