This was a comparative study between gastric tube esophageal replacement positioned at retrosternal route (group1) versus transhiatal route (group2) for either patients of esophageal atresia or post corrosive esophageal stricture focusing on operative, early post-operative complications and late cervical anastomotic stricture. Study included 20 patients (14 retrosternal & 6 transhiatal) of mean age 4 years 2 months old who were indicated for esophageal replacement. 2 patients (1 from each group) died (10%) where death was related to respiratory complications. Mean operative time for group 1 was 75 minutes and for group 2 was 120 minutes. Conduit necrosis didn’t occur in any patient, mechanical ventilation was indicated for 2 patients (10%). Mild to moderate chest infection developed in 8 patients (40%). Cervical fistula with mean duration 2 weeks post-operatively developed in 13 patients (65%) with spontaneous resolution after introduction of semisolid feeding. Late anastomotic stricture with clinical evidence of dysphagia in 12 patients (60%) with different degrees of severity and all resolved on regular surgical dilatation. Retrosternal approach seems to be of less serious operative hazards and shorter operative time compared to transhiatal approach otherwise results are equivocal.