Choanal atresia is the congenital failure of one or both posterior nasal apertures to communicate with the nasopharynx and about 50% of these patients are accompanied with other congenital defects. The incidence is one in 8,000 live births, with a female to male preponderance of approximately 2 : 1. Recently the authors have experienced two cases of congenital choanal atresia each by transpalatal approach and transnasal approach with endoscopy.