Laryngomalacia is the most common laryngeal anomaly and cause of stridor in newborns. Up to 20% of infants with laryngomalacia present with life-threatening disease that necessitates surgical management in the setting of severe airway obstruction and feeding disorders. Surgical correction of laryngomalacia has evolved over the past century from open tracheostomy to endoscopic modalities. This article provides a guide to patient assessment, surgical indication, operative technique, and perioperative management of patients with laryngomalacia. A review of surgical outcomes and complications is presented. Medical comorbidities often accompany patients with the least successful outcomes. Although complications are rare, they most commonly include persistent disease, supraglottic stenosis, and lower respiratory tract infections.