From 2006 to 2016, we treated 300 newborns with AS in the Republican Training and Methodological Center for Neonatal Surgery at the Republican Clinical Center of Neonatal Surgery. Out of 300 patients, -263 (87.7%) underwent surgery. 37 (12.3%) children died before surgery. Out of 263 operated on children 232 (88,2%) underwent primary esophageal anastomosis. Upper esophagostomy and Kader gastrostomy were performed in 25 (9,5%) children. The remaining 6 (2.3%) newborns underwent the first stage of correction of congenital malformations (elongation according to Foker-2, sigmastomy for anorectal anomaly - 3, duodeno-duodenoanastomosis-1). Methodological and tactical approaches to the diagnosis and surgical treatment of children with AS changed during the study period. Therefore, we divided clinical material into two groups. The comparison group included 69 children with AS who were treated in 2006-2009. In an effort to improve treatment outcomes, we analyzed the results of diagnosis and treatment in neonates in the first group. The findings allowed us to change the approaches to diagnosis and treatment of patients with AS. The main group included 231 newborns from 2010-2016, in whom the developed methodological and tactical approaches were applied.