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The Mustard procedure is a pioneering cardiac surgical technique primarily utilized to correct transposition of the great arteries (TGA), a congenital heart defect where the two main arteries leaving the heart are switched, leading to inadequate oxygenation of the blood. This procedure was first introduced by Dr. Dwight Mustard in the late 1960s and has since been a cornerstone in the surgical management of TGA, particularly before the advent of newer techniques like the atrial switch operations. The fundamental principle of the Mustard procedure involves redirecting the blood flow within the heart to ensure that oxygen-poor blood and oxygen-rich blood are separated correctly. During the operation, the surgeon creates a baffle or barrier made from synthetic material, which is positioned in the atrium of the heart. This baffle directs the deoxygenated blood returning from the body into the left atrium and then into the left ventricle, enabling it to be pumped into the aorta. Conversely, oxygenated blood from the lungs is directed into the right atrium, allowing it to flow into the right ventricle and subsequently into the pulmonary artery. The surgery is typically performed on infants shortly after birth, as early intervention significantly improves long-term outcomes and reduces the risk of associated complications, such as heart failure and hypoxemia. The Mustard procedure is usually conducted through a median sternotomy, where the patient's chest is opened to access the heart. The surgery utilizes cardiopulmonary bypass to temporarily take over the function of the heart and lungs, allowing the surgeon to operate on a still, bloodless field. Postoperatively, patients may experience various complications, including arrhythmias, progressive ventricular dysfunction, and potential obstruction at the site of the baffle, which necessitates careful monitoring and follow-up. Although the Mustard procedure was a groundbreaking advancement in congenital heart surgery, it has gradually been replaced by the Senning procedure and, more recently, arterial switch operations, which offer improved outcomes and reduced long-term complications. Nevertheless, the Mustard procedure remains an important historical reference in the evolution of cardiac surgery for TGA, demonstrating the ingenuity and adaptability of surgical techniques in response to the challenges of congenital heart defects. Patients who undergo this surgical intervention, when followed up appropriately and managed for any arising complications, often lead relatively healthy lives into adulthood. Today, the legacy of the Mustard procedure continues to influence current practices in the surgical management of congenital heart diseases, emphasizing the need for an individualized approach tailored to each patient's unique anatomical and physiological circumstances.