This chapter presents diverse cases of tracheo-oesophageal fistulae highlighting the diagnostic and therapeutic challenges posed by these conditions. Case summariesCase summaries include instances such as a 57-year-old male with a chronic cough and vomiting found to have a fistula between the oesophagusOesophagus and right lower lobe bronchus, successfully managed through thoracotomyThoracotomy and ligation. Another case involves a 34-year-old female with a history of TB presenting with a fistula from the oesophagusOesophagus to the right lower lobe, necessitating lobe resection. Additionally, cervical tracheo-oesophageal fistulasTracheo-oesophageal fistula, often secondary to medical interventions, are discussed, with emphasis on meticulous surgical planningSurgical planning and techniques, as seen in cases involving a 32-year-old female with a congenital fistula and a 75-year-old male with a longstanding fistula complicated by recurrent aspiration pneumonia. These cases underscore the importance of tailored management strategies and multidisciplinary collaborationMultidisciplinary collaboration in addressing the varied presentations of tracheo-oesophageal fistulasTracheo-oesophageal fistula.