Fistulas between the airway and esophagus can be congenital or acquired and can be categorized as tracheo-esophageal or broncho-esophageal fistulas. Although congenital anomalies are usually recognized 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 up food particles, occasionally combined with bronchiectasis. 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 most cases dying within weeks or months. Acquired tracheo-esophageal fistula can also be caused by tracheal catheter balloon compression of the trachea, surgical trauma, blunt injury and foreign bodies. It can be detected by CT examination, and the diagnosis can be clarified by fiberoptic bronchoscopy and barium swallow. The treatment mainly relies on surgery, and those who are not qualified to tolerate surgery can try medical glue closure treatment. 1.Waterston grouping method Group A: weight greater than 2.5kg, general condition is good. Group B1: weighing 1.8-2.5kg, in good condition. Group B2: weight greater than 2.5kg, with moderate pneumonia or deformity. Group C1: weight less than 1.8kg. Group C2: any weight with severe pneumonia or severe malformation. After comprehensive evaluation of the children in the above groups, some authors advocate that group A should undergo immediate one-stage esophageal anastomosis; group B should delay one-stage anastomosis, i.e., gastrostomy, treatment of comorbidities such as pneumonia and sclerosis; and group C should undergo staged surgery. In fact, it should be considered individually according to the specific situation of the child and the medical conditions and level.