The clinical, radiologic, and pathologic features of four children with uncommon variations of congenital bronchopulmonary foregut malformations are presented. In each case, the malformation included a persistent communication between lung tissue and the gastrointestinal tract. One case, in which an esophageal bronchus was associated with esophageal atresia and tracheoesophageal fistula, is considered extremely unusual. The embryogenesis of these communicating bronchopulmonary foregut malformations is outlined, and the key radiologic features are discussed.