The authors report on a child with tracheal agenesis who survived for 6 years and 10 months. A female infant was born with respiratory distress and an absence of audible cry. With mask ventilation, gastrostomy and division of the esophagus was performed just after birth. She was well ventilated with an endotracheal tube inserted through the cervical esophagostomy after thoracic esophageal banding. An accidental extubation caused her anoxic encephalopathy at 9 months of age. She had been alive without artificial ventilatory support until she died of acute esophageal bleeding.