A common upper airway and digestive tract is a rare congenital anomaly that is usually fatal and its exact incidence is not known. It is a diagnostic challenge as it requires high index of suspicion. It should be considered in a neonate with respiratory distress in a non-vigorous baby requiring endotracheal intubation. which is difficult even in expert hand. https://www.roneverhart.com/S-mores-Snack-Mix-2LB-Bag/