Esophageal atresia encompasses a group of congenital anomalies comprising an interruption of the continuity of the esophagus combined with or without a persistent communication with the trachea. Esophageal atresia is a relatively common congenital malformation occurring in one in 2500–3000 live births. During the last 40 years there has been a steady improvement in the overall survival rate due to early diagnosis and prompt referral, improvements in preoperative care and diagnosis and treatment of associated anomalies, advances in anesthetic techniques and sophisticated neonatal intensive care. Results have improved with time, as the survival rates have improved, also the number of patients that had successful primary esophageal anastomosis have increased with a decrease in the rates of leakage. However, the mortality rate is still high in comparison to published results. Also, the survival rates in comparison to Waterston and Spitz classification are still low, indicating that our results are still unsatisfactory. Outcome was greatly affected by several preoperative factors such as delay in referral of patients affecting the age on admission and operation, chest condition preoperatively, cardiac anomalies, birth weight and other associated anomalies. The surgical technique also affected outcome as it affected post operative complications.