Peri-operative cardiac arrhythmias are not uncommon in patients with underlying diseases or internal environment disturbance, some of which might be fatal and induce organ dysfunction. A quick recognition and proper treatment for malignant cardiac arrhythmias or symptomatic arrhythmias and treatment for underlying diseases, would prevent patients from deteriorating. Recognition and treatment for common peri-operative cardiac arrhythmias are reviewed in detail, including high-quality cardiopulmonary resuscitation, electrical cardio-version, cardio-pacing, anti-arrhythmic medicines and some cautions during these managements. Most evidence-based recommendations come from recent international/domestic guidelines or expert consensus, for example, AHA or ESC CPR guidelines, supra-ventricular arrhythmia management guidelines, atrial fibrillation management guidelines, pre-operational evaluation in non-cardiac surgery, ventricular arrhythmias management guidelines and so on. As a conclusion, the emergency of peri-operative arrhythmias depends on its effect on hemodynamics, ie, how life-threatening it is. The effect of some peri-operative factors, such as post-surgery bleeding, hypoxemia and so on should be taken in account while treating peri-operative arrhythmias.