Fifteen cases of esophageal atresia with tracheo-esophageal fistula, the common anomaly in this group, have been reported. All were operated upon in two Canadian centers by a technic of end-to-side anastomosis between the blind end of the upper esophageal pouch and the superior side of the ligated, but not resected, tracheo-esophageal fistula. Gastrostomy was electively utilized in the first three cases done by this method, but has been eliminated in subsequent cases. Oral feedings commence 24–48 hours postoperatively. There has been no case with recanalization of the fistula where anastomosis was carried out at the time of the ligation of the fistula. Postoperative dilatation was required in two cases, one in which there was a double fistula and the more proximal fistula was resected and closed with a subsequent leak, the other where sixteen 00000-silk sutures were utilized to make the anastomosis. The postoperative esophageal motility begins early and functions well, both clinically and by assessment of the cine-esophagrams which were carried out serially in every case. The operative mortality has been nil—one patient died 18 months after surgery from congenital heart disease. The morbidity has been low. It would seem that the utilization of adult surgical principles, so well proven in the treatment of acquired conditions in the older patient, may not be transferrable in every instance to the treatment of congenital lesions in the newly born. In the newborn, it would appear that the separation of the trachea and the esophagus can be affected by the technic described. The simple ligation of the tracheo-esophageal fistula in the presence of an esophagus that possesses an early adequate lumen is unaffected by peri esophageal dissection and by diminution of its blood supply. Fifteen cases of esophageal atresia with tracheo-esophageal fistula, the common anomaly in this group, have been reported. All were operated upon in two Canadian centers by a technic of end-to-side anastomosis between the blind end of the upper esophageal pouch and the superior side of the ligated, but not resected, tracheo-esophageal fistula. Gastrostomy was electively utilized in the first three cases done by this method, but has been eliminated in subsequent cases. Oral feedings commence 24–48 hours postoperatively. There has been no case with recanalization of the fistula where anastomosis was carried out at the time of the ligation of the fistula. Postoperative dilatation was required in two cases, one in which there was a double fistula and the more proximal fistula was resected and closed with a subsequent leak, the other where sixteen 00000-silk sutures were utilized to make the anastomosis. The postoperative esophageal motility begins early and functions well, both clinically and by assessment of the cine-esophagrams which were carried out serially in every case. The operative mortality has been nil—one patient died 18 months after surgery from congenital heart disease. The morbidity has been low. It would seem that the utilization of adult surgical principles, so well proven in the treatment of acquired conditions in the older patient, may not be transferrable in every instance to the treatment of congenital lesions in the newly born. In the newborn, it would appear that the separation of the trachea and the esophagus can be affected by the technic described. The simple ligation of the tracheo-esophageal fistula in the presence of an esophagus that possesses an early adequate lumen is unaffected by peri esophageal dissection and by diminution of its blood supply. A duo centros canadian, 15 neonatos con atresia esophagee e fistula tracheo-esophagee del typo le plus commun esseva operate per medio de un technica simplificate: Ligation sin division del fistula tracheo-esophagee e anastomose termino-a-termino del sacco cec superior con le aspecto superior del esophago distal con respecto al fistula ligate. Nulle mortalitate operatori e un basse morbiditate, insimul con meliorate mobilitate esophagee secundo un evalutation cine-esophagographic, es reportate. A duo centros canadian, 15 neonatos con atresia esophagee e fistula tracheo-esophagee del typo le plus commun esseva operate per medio de un technica simplificate: Ligation sin division del fistula tracheo-esophagee e anastomose termino-a-termino del sacco cec superior con le aspecto superior del esophago distal con respecto al fistula ligate. Nulle mortalitate operatori e un basse morbiditate, insimul con meliorate mobilitate esophagee secundo un evalutation cine-esophagographic, es reportate.