In Tetralogy of Fallot, insufficient blood flow to the lungs due to severe right ventricular outflow tract obstruction is a key finding. This condition leads to a drop in blood oxygen levels, causing cyanosis (bluish discoloration) in children's tongues, lips, and nails. These cyanotic episodes are known as 'Tet Spells' or 'Hypoxic Spells'. While these spells can sometimes occur spontaneously, their severity may increase, especially during situations that can further reduce pulmonary blood flow, such as crying or defecation, and they are generally more common in the mornings. Various measures are taken in children to prevent these attacks. Anemia, if present, is corrected, and it is important to prevent excessive crying. In cases of recurrent or severe Tet Spells, medications that help widen the right ventricular outflow tract may be used. Furthermore, if the cyanotic spells do not improve despite medication, it is a significant indicator that the time for surgical intervention has arrived.