Introduction: Choanal atresia occurs when the posterior nasal cavity fails to communicate with the nasopharynx.. This anomaly has a reported incidence ranging from 1 in 5,000 to 1 in 8,000 live births. The clinical presentation of bilateral cases present as newborns with cyanotic events. A variant occurs later in life with mouth breathing, recurrent sinusitis, chronic rhinorrhea, otitis media, and defects of speech. The diagnosis is made clinically by failure to pass a catheter through the nose into the nasopharynx. Computed tomography (CT) is used to confirm the diagnosis and reveal the nature and thickness of the atresia. Bilateral atresia requires an initial intervention to establish an oropharyngeal or orotracheal airway before surgery.