Congenital bilateral atresia of the choana is a rare anomaly. It is a closure of the posterior nares by a membranous and/or osseous partition. It causes early respiratory distress in the neonate. The history and presenting symptoms seldom cannot simulate those of severe respiratory distress in the newborn. The anaesthesist can easily make the diagnosis when he observes a "cyclic pattern of respiratory distress": chest retraction and cyanosis which disappear with crying. The purpose of this present case is to emphasize both anaesthetic and surgical approaches to the management of this type of lesion.