Pediatric laryngotracheal reconstruction efforts result in decannulation rates of 85-90%. There is a general paucity of of reports on technical factors which may contribute to surgical treatment failure. Yet, important pitfalls must be recognized. In revision surgery specifically, techniques must be tailored to the individual patient to address these pitfalls and avoid errors which may subsequently make decannulation nearly impossible. This course, from an experienced and well established pediatric airway surgeon will address pitfall in primary and revision airway reconstruction, ideal timing of procedures, specific technical pearls supported by video demonstrations, stenting needs, and a review of holistic patient factors which may contribute to failure.