Esophageal anomalies continue to present a challenge to the pediatrician, the surgeon, and the nursing staff. The rocky road to recovery is fought with a multitude of life-threatening complications demanding immediate attention and requiring all of the services of a specialized institution designed and equipped for the care of infants. In our series, for the past seven years, we can report a 100% recovery following surgical correction of the anomaly for 37 consecutive infants with a birth weight greater than 2,000 gm. One additional infant died before the anomaly could be corrected. Therefore, 97% of all infants admitted with a weight of over 2,000 gm have survived. For those with a birth weight of less than 2,000 gm, the outlook is most dismal, with only 2 survivors out of 11 infants. An emergency gastrostomy was performed with local anesthesia on each infant as soon as the diagnosis was confirmed. The definitive operation was then delayed for from 3 to 21 days for treatment of pneumonia, hyperbilirubinemia, or other anomalies of a more urgent nature. The over-all recovery rate for the last seven years has been 80% for 49 infants.