**Abstract**

Managing the airways during anesthesia in pediatric patients with craniofacial abnormalities is a challenging and stressful situation for even experienced anesthesiologists. The prerequisites for a good management are a thorough understanding of the normal anatomy of the upper airway, its normal changes with growth, and the key features of congenital craniofacial abnormalities and their impact on the airways resulting in management difficulties. This chapter aims to provide an overview of various craniofacial anomalies and their airway management specificities. These include cleft lip and palate with or without Pierre Robin syndrome, craniofacial dysostosis (including Crouzon, Pfeiffer, and Apert syndromes), mandibulofacial dysostosis/Treacher Collins syndrome, hemifacial microsomia, Down's syndrome, and other anomalies.

**Keywords:** congenital syndrome, craniofacial anomalies, difficult airways, anesthesia, mandibulofacial dysostosis
