We report the anesthetic management of Cesarean section in a pregnant (31 weeks) woman with dilated cardiomyopathy. She had dyspnea and chest pain which were signs of congestive heart failure. The left ventricular ejection fraction was 38%. Anesthesia was induced and maintained with fentanyl, midazolam and vecuronium. There was no significant cardiovascular changes in the mother during the operation. The baby was apneic and showed no movement at birth, but he was immediately intubated and his condition became almost normal on the following day. In the anesthesiological management of Cesarean sections with cardiac disease, general anesthesia with fentanyl can be used to minimize cardiovascular changes in the mother as long as the baby is immediately resuscitated after delivery.