Tracheoplasty using costal cartilage graft was carried out in a five-month-old girl who had congenital tracheal stenosis extending from the cricoid ring down to the carina. The operation is performed through a median sternotomy with extracorporeal membrane oxygenation for respiratory support. A longitudinal tracheal incision was performed from the cricoid ring to carina. The costal cartilage graft was sutured to fill the defect of the trachea. The patient has been free of respiratory distress for two years.