ABSTRACT.This paper describes the tracheomalacia seen in two groups of children: in association with tracheo‐oesophageal fistula, and in so‐called “innominate artery compression”. The underlying cause in both groups is believed to be related to malformation and deficiency in the cartilage of the tracheal wall, with an increase in the width of the membranous trachea. Symptoms in tracheomalacia range from mild to severe. Indications for surgery are “reflex apnoea”, severe respiratory obstruction, or severe and repeated respiratory infections with retention of sputum and cyanotic attacks. Endoscopy is essential to confirm the cause, and the need for surgery. The operative technique of aorto‐tracheal suspension is described, and the results in 20 patients submitted to tracheopexy since January 1969