Effective and prompt pediatric airway management is an essential component of the successful management of acute respiratory failure in children. Applying Non-Invasive Ventilation (NIV) with Nasopharyngeal Airway (NPA) can facilitate managing these children with acute respiratory dysfunction, till the pathophysiological process resolves. Observation of potential complications of NPA is warranted, as displacement into the esophagus occurred in this reported patient.  Integrating proper fixation method for these nasopharyngeal airways in children undergoing non-invasive mechanical ventilation may help in maintaining patent upper airway, as well as limiting potential complications of airway adjunct displacement.