Retrograde coronary sinus perfusion is a technique being used to deliver cardioplegia during cardiac surgery. This article reviews the history behind its use, the procedure for delivery, and the advantages and limitations that exist in comparison with the standard antegrade infusion of cardioplegia via the aortic root. The complications resulting from the technique of retrograde coronary sinus perfusion are rare. Nursing considerations specific to the potential complications of this patient population are discussed.