The residual pulmonary regurgitation can lead to heart failure in patients with repaired tetralogy of Fallot (rTOF). We aimed to explore the possible impact of pulmonary area on pulmonary retrograde flow and pressure. Patients with rTOF presented higher retrograde flow than normal controls. The area ratio correlated with with retrograde flow in rTOF patients. Negative correlations between area ratio and pressure difference was also presented in patients. In conclusion, pulmonary area was correlated with retrograde flow and pressure difference in rTOF patients. The information of appropriate pulmonary area ratio might be helpful for treating the pulmonary stenosis in patients with rTOF.