Article InfoIn surgical practices in management of esophageal atresia with or without tracheoesophageal fistula, the gap length between the two ends play an important role in the management modality and also affect the outcome of surgery. We aimed to assess the critical gap length for the safe esophageal anastomosis and assess the outcome of the patients after intervention. This was a prospective study continued from February, 2011 to September, 2013 and included 25 neonates (7 males and 18 females) who had Esophageal atresia with distal tracheaoesophageal fistula who were admitted in Al Zahra`a teaching hospital, in Al -Najaf province, middle of Iraq. The gap length was measured without mobilization of oesophagus, and patients were categorized into three groups according to the gap length, group I (gap length < 2cm), group II (2-3 cm) and group III (> 3cm). Tracheoesophageal fistula was identified and closed. These complications were mainly found in patients of Groups II and III.