INTRODUCTION: Neonatal upper airway obstruction secondary to micrognathia can be managed with conservative or surgical interventions.Traditionally, severe upper airway obstruction was managed with a tracheostomy and endotracheal intubation.Although tracheostomy and endotracheal intubation may be life saving, it is associated with high rates of complications and can lead to developmental problems.More recently, mandibular distraction osteogenesis has been utilized to relieve micrognathia associated airway obstruction.