Intra vitam diagnostic procedures revealed a complete laryngo-tracheo-oesophageal cleft in a premature infant with respiratory distress. Anamnesis together with clinical and roentgenological symptoms suggested the diagnosis of oesophageal atresia or oesophago-tracheal fistula. The diagnosis of "oesophago-trachea" was finally confirmed by laryngo-tracheoscopy. The morphologic defect in this case was combined with partial supradiaphragmatic dislocation of the stomach and with intestinal malrotation.