Infant cardiac fibroma is a rare but life-threatening condition, characterized by anatomical complexity and postoperative recurrence risks, posing significant challenges in clinical management. This article presents a case of a 3-month-old male infant managed with multimodal contrast-enhanced ultrasound (CEUS) combined with transthoracic echocardiography (TTE), enabling precise preoperative assessment, real-time intraoperative navigation, and dynamic postoperative surveillance. CEUS effectively identified tumor microcirculation patterns, guided subtotal resection decisions, and facilitated early detection of residual lesions and cardiac dysfunction. Supported by a review of recent literature, this case highlights the innovative role of CEUS in infant cardiac tumor management.