In 1988-1989 the authors diagnosed and treated in the Paediatric Faculty Hospital in Prague 5 - Motol three neonates with a rare developmental anomaly--a cleft of the larynx, trachea and oesophagus. This rare anomaly was not yet published in our literature. Once a grade II cleft was observed, twice a grade III cleft. All neonates died. The authors discuss diagnostic and therapeutic problems associated with successful therapy. Early diagnosis, depending on the evaluation of the contrast examination of the deglutition pathways and endo scopic examination, are the basis for successful surgical treatment.