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We present a full-term neonate with a postnatal diagnosis of a sternal cleft. Cardiac evaluation was otherwise remarkable for a patent ductus arteriosus and patent foramen ovale. Computed tomography scan confirmed the absence of a sternum except for a small inferior portion, including the xyphoid process. The patient underwent primary repair at five days of age through a midline incision where an absence of pericardium anteriorly was noted. She was extubated successfully the next day and discharged home on postoperative day 3. On follow-up examination, her sternum has been healing well without any clinical concerns. We advocate early repair of such defects in order to allow primary closure in a tension-free manner.