In industrialized countries, most congenital pulmonary malformations are discovered during pregnancy by means of ultrasound screening and confirmed by subsequent MRI. This allows performing prenatal in utero procedures when necessary, facilitates the timely presence of the appropriate health care team at birth and planning of follow up care. However, some malformations are not discovered until later when a complication (infection, unexplained intraoperative hypoxemia, respiratory failure) occurs.The aim of this educational review was to describe the congenital malformations of the large conducting airways. Laryngeal malformations (e.g., laryngeal cleft) and esophageal atresia with or without tracheo-esophageal fistula will not be considered but are referred to previous reviews. 1,2 We will review the origin, development, and impact of these "macro level" malformations and discuss their surgical and anesthetic implications. Although one-lung ventilation will often be considered, it will not be described in detail but referred to elsewhere 3 and also in a separate review in this special issue.