Fistulas between the airway and esophagus can be congenital or acquired and can be divided into tracheo-esophageal and broncho-esophageal fistulas. Although congenital anomalies are usually detected in the newborn, the former type may not be definitively diagnosed until adolescence or even adulthood. Most cases have a long history of choking on breastfeeding or coughing, often coughing up food particles, and occasionally combined with bronchodilation. The most common cause of acquired abnormal airway and esophageal traffic is esophageal cancer, which can occur after radiation therapy in some cases, with an incidence of up to about 5.3%. Once this complication occurs, the prognosis is extremely poor, with death occurring within weeks or months in most cases. Acquired tracheo-esophageal fistulas can also be caused by tracheal tube balloon compression of the trachea, surgical trauma, blunt injuries and foreign bodies. It can be detected by CT examination, and definitive diagnosis can be made by fiberoptic bronchoscopy and barium swallow. Treatment mainly relies on surgery, and those who are not in a position to tolerate surgery can be treated with medical adhesive closure. Early surgical treatment is recommended for fistulas between the airway and esophagus, with fistula repair, resection and/or esophageal reconstruction, and short-term gastrostomy, depending on the condition. This allows for feeding and control of aspiration pneumonia. The prognosis is better, but postoperative follow-up observations should be noted. Some patients may still have recurrent respiratory infections due to the combination of incomplete closure of the lower esophageal sphincter followed by retroperistalsis, and it is advisable to sleep and feed in a head-high position.