Esophageal atresia is complex congenital anomaly of respiratory tract occuring often associated with anomalies of other systems and chromosomal abnormalities. This congenital anomaly is a surgical emergency. The management mode of Esophageal atresia/ Tracheoesophageal Fistula in the premature, low birth weight neonate remains controversial. Traditionally, treatment has been based on a staged approach. The primary repair of Esophageal atresia and fistula closure is achievable in Low Birth Weight infants and offer a good treatment in the absence of additional severe malformations. Treatment of these neonates should not be limited to tertiary pediatric surgical centers, contrarily it is also achievable in secondary heath care centers. Near cooperation with neonatal intensivist and the pediatric surgeon is essential for good survival.