It is commonly believed that the branchial anomalies are persistent remnants of the embryologic branchial apparatus. These anomalies are originated from branchial cleft and most commonly involved in second branchial deft. Clinically they present palpable mass, discharge from fistula, recurrent infection due to obstruction of Gstula tract. As respiratory symptoms, they may present hoarseness, preceeded by or associated with upper respiratory infection. However, it has not been reported that they caused airway obstruction in newborn infants. Wc experienced a case of the fourth branchial deft cyst in a 2 day old infant who showed respiratory difficulty due to airway obstruction.