Bilateral congenital choanal atresia is a rare anomaly of the posterior nasal choanae. The etiology of this anomaly is unknown : it may be teratogenic or genetic. Bilateral nasal obstruction in the infant involves an imminent risk of suffocation because the infant does not breathe through the mouth during the first few weeks of life due to anatomic conditions of the mouth and pharynx. Therefore, bilateral congenital choanal atresia is an example of such a life threatening condition that calls for immediate recognition and treatment. Computed tomographic scans have improved diagnostic differentiation between membranous and bony atresia, and this has been helpful in planning surgery. Recently, the authors have experienced one case of bilateral congenital choanal atresia in 16 years old female who had surgical correction by transpalatine approach with good operation result.