None of the congenital anomalies offer a greater challenge than those of the esophagus. Though steady progress has been made in this field, much remains to be accomplished. Diagnosis must be made earlier; surgical treatment must be improved; preoperative and postoperative care must be better managed if the high mortality is to be reduced to a satisfactory rate. In 1670, Durston * recorded the first instance of a simple atresia of the esophagus. Thomas Gibson, of London,† in 1696 described atresia of the esophagus with tracheoesophageal fistula. During the following 232 years, only 132 verified cases of the anomaly were reported. Current experiences, based particularly upon findings at rather large children's hospitals, suggest that congenital lesions of the esophagus occur once in each 2500 births, a rate approximately the same as that for imperforate anus. In 1929, Vogt3 suggested a good working classification of congenital esophageal atresias. Holinger4 presented