The authors report a child with tracheoesophageal fistula secondary to disk battery ingestion. With respiratory compromise precluding expectant therapy and primary repair not achievable, gastric interposition and tracheal patch repair were undertaken in the acute phase. To the authors' knowledge, this is the first report of primary gastric interposition for traumatic tracheoesophageal fistula and suggest that immediate reconstruction can give an outcome at least as good as other reported approaches.