Tracheoesophageal fistula (TEF) is one of the most common neonatal emergencies. Polyhydramnios was the most frequent finding and stomach size and presence were not contributory to the diagnosis antenatally. The common presentation was excessive salivation and vomiting, respiratory distress after birth, recurrent pneumonia later in life. The incidence is 1 in 3000 to 1 in 4500 live births. Early recognition, prompt and efficient management of the cases was possible due to multidisciplinary approach by the radiologist, neonatologist, intensivist, and the paediatric surgeon. A precise surgical technique with proper mobilization of upper pouch and good anastomosis is key to successful outcomes.