Obstructive apnea, especially OSA, is a common problem in pediatric practice. In young infants, craniofacial anomalies may be the most common contributor to OSA. Complications include failure to thrive, metabolic alkalosis, and respiratory distress which can be life-threatening. In children over the age of 2 years, adenoidal and tonsillar hypertrophy is more commonly the cause of upper airway obstruction. The complications of growth failure, cor pulmonale, and adult respiratory distress syndrome were discussed. Obstructive sleep apnea can cause significant complications in both infants and children. These problems can be life-threatening, cause delay in growth and development, or cause subtle long-term learning disabilities. Surgical management of the airway should correct the metabolic and cardiorespiratory disorders. The correction of learning disabilities has not yet been demonstrated.