Objective To explore the value of standardized pulmonary indexes based on echocardiography in the prediction of the prognosis of repaired tetralogy of Fallot (TOF). Methods 465 TOF patients who underwent complete repair from 2003 to 2020 in our hospital were included, pulmonary valve annulus Z-score (PVAZ), main pulmonary artery Z-score (MPAZ) and Nakata index were calculated based on echocardiographic evaluation. The postoperative outcomes were followed up. Receiver operating characteristic (ROC) curve was used to predict the practice of transannular patch (TAP). Correlation analysis was performed between the pulmonary indexes and clinical data during perioperative management. ROV curve was again used to confirm best cut-off values and conduct survival analysis. Results A total of 413 cases (88.8%) underwent TAP during complete repair. For the practice of TAP, when PVAZ=-2.725, area under the curve (AUC)=0.740, sensibility=0.528, specificity=0.860. MPAZ and Nakata index turned out to be well-related to the perioperative results, with lower MPAZ and Nakata index indicating longer time of operation and postoperative care. There were 23 cases (4.95%) of death during a median follow-up time of 2.03 years. PVAZ=-3 and MPAZ=-3.5 were confirmed as the cut-off values and the survival differences between the groups were statistically significant. Conclusion Standardized pulmonary indexes based on echocardiographic evaluation are good indicators to predict the prognosis of repaired TOF, which may be of great guiding significance in the clinical hazard stratification.