Pediatric open airway surgery was popularized in the 1970s, utilizing laryngotracheoplasty to repair subglottic stenosis. Open airway surgery continues to evolve, and this course seeks to familiarize the audience with patient selection for open vs endoscopic surgery, and pre-operative evaluation and optimization. Specific operations to be discussed include laryngotracheal reconstruction, cricotracheal resection, slide tracheoplasty, laryngeal cleft repair, and revision surgery. Specific pathologies discussed will include subglottic stenosis, transglottic stenosis, tracheal stenosis, complete tracheal rings, laryngeal webs, and subglottic hemangiomas. Both single stage and double stage techniques, as well as differing stenting methods will also be discussed.This year we plan to spend more time discussing direct surgical tips and nuances, as a response to audience feedback. Each year we discuss a few specific pathologies and rotate these each year. This is the companion course to "Pediatric Endoscopic Airway Surgery: State of the Art."