The object of this paper is to analyse our experience at the Hospital for Sick Children, Great Ormond Street (London, U.K.) in the management of 10 patients with posterior laryngeal clefts during the past 5 years. Of these 10 patients, 4 had minor clefts not causing significant laryngeal incompetence. The other 6 patients had clefts extending below the cords requiring repair. Other congenital abnormalities were prevalent in this series, particularly oesophageal abnormalities. The frequency of this association is stressed, the problems of diagnosis and management discussed and recommendations made to avoid delay in identification of these abnormalities.