A 3 year old child with a tight and angulated stricture at the cervical oesophagogastric anastomosis developed marked dysphagia. Initial attempt at Savary-Gilliard bougienage failed because the bougies tended to coil up in the proximal oesophageal pouch. He was subsequently managed successfully by serial Gruntzig balloon catheter dilatation guided by flexible endoscope, with complete amelioration of dysphagia. The methodology of balloon catheter dilatation is described and its advantages for use in high cervical oesophageal stricture discussed.