Objective — to compare incidence of postoperative complications in infants undergoing aortic arch reconstruction under deep hypothermic circulatory arrest (DHCA), selective antegrade cerebral perfusion (SACP) or full-flow perfusion with double arterial cannulation (DAC). Material and methods. A prospective analysis included 45 patients who underwent aortic arch reconstruction in 2016—2019. Patients were randomized into three groups depending on perfusion strategy — DHCA (n=15), SACP (n=15) or DAC (n=15). Primary endpoint of clinical efficacy was incidence of early postoperative complications including acute renal failure (estimated with pediatric RIFLE score), neurological events (confirmed by MRI) and in-hospital mortality. Results. Incidence of acute renal failure was similar in all groups (p=0.64). Concentrations of creatinine in blood within 3 postoperative days were also similar in 3 groups (p=0.86, p=0.45 and p=0.26, respectively). Incidence of neurological events was significantly lower in groups with continuous cerebral perfusion (SACP and DAC) compared with DHCA group (SACP/DHCA p=0.013; DAC/DHCA p=0.013). Early postoperative mortality in both DHCA and SACP groups was 13.3%, in DAC group — 6.6% (p=0.70). Significant predictors of acute renal failure were high doses of inotropic support (VIS >12) and septal defects (p=0.019 and p=0.046, respectively). Absence of cerebral perfusion with low cerebral saturation were the predictors of neurological events (p=0.04 and p=0.02, respectively). Conclusion. Methods of continuous perfusion under moderate or mild hypothermia are followed by lower risk of neurological events compared with DHCA. However, there is no significant difference regarding kidney injury between groups.