Summary Objective Determine the outcome following tracheocutaneous fistula excision with tracheal closure in children, and in particular, evaluate the occurrence of air leak and the implications this has on recommended duration of post-operative hospitalisation. Methods Retrospective chart review in a tertiary pediatric hospital. Results There were 16 patients (6 male:10 female), 15 of whom underwent tracheocutaneous fistula excision with primary wound closure. The mean age at decannulation was 54.2 months and the mean age at repair was 66.2 months. All patients had successful closure of their wound and there were no complications associated with tracheal air leak and subcutaneous emphysema. One patient required the initiation of nocturnal continuous positive airway pressure therapy following repair, and a further two patients had complications related to urinary tract infection and upper respiratory tract infection. Conclusions Our experience suggests that management of pediatric tracheocutaneous fistulae by excision and primary closure with a short period of post-operative observation can be undertaken safely.