Esophageal atresia and tracheoesophageal fistula may occur as separate entities but usually occur in combination.The first report of esophageal atresia with tracheoesophageal fistula was done by Thomas Gibson in 1696.In1941, Haight and Towlseg performed the first successful primary repair,recently we were experienced a case of esophageal atresia with distal tracheoesophageal fistula in infant patient who presented the symptoms of dyspnea and vomiting.The operation was performed transpleurally through right 4th intercostal space.Patient tolerated all the operative procedure and recovered uneventflly.He was well-being without other problem.