OBJECTIVE: To investigate the timing of balloon dilation for the treatment of anastomotic stricture after neonatal congenital esophageal atresia. METHODS: The clinical data of 15 children with anastomotic stricture after congenital esophageal atresia were retrospectively analyzed, and balloon dilation was performed under fiberoptic gastroscopy or electronic gastroscopy in all of them. RESULTS: The diameter after balloon dilation was 0.3-1.2 cm, and the number of dilation in individual children ranged from 2 to 6 times. The treatment was effective when the respiratory symptoms gradually reduced and disappeared, the diet improved from fluid to solid state, and the weight gradually increased. 43 out of 48 balloon dilatations were completed, and the completion rate was 89.6%. The rate of completion was 89.6%. 14 cases were effective, and 1 case underwent gastrostomy after dilatation without improvement. Conclusion: 1 to 3 months after esophageal atresia is the best time to treat esophageal stricture. Early detection and treatment of postoperative esophageal stricture by balloon dilation in neonates with congenital esophageal atresia is an effective and safe treatment. Top: Esophageal stricture after esophageal atresia, leading to choking and aspiration pneumonia. Bottom: We performed gastroscopic balloon dilatation on a small infant one month after surgery, which significantly improved the child’s respiratory symptoms, while the child’s eating speed and diet volume improved significantly, and thus the child’s growth and development were basically normal. It is also safer to dilate under direct vision than under radiology fluoroscopy, less likely to lead to medically induced perforation (e.g., esophageal fistula), and free of radiation.