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Right thoracotomy for oesophageal atresia (OA) with dextrocardia is technically challenging due to the heart being in the operative field, and also due to the possibility of right-sided aortic arch. We report a neonate with longgap OA with tracheo-oesophageal fistula (TOF), dextrocardia, and left-sided aortic arch who was successfully operated by using right thoracotomy. On the basis of our review of the literature and our experience from this case, we found that conventional right thoracotomy is appropriate for OA+ TOF associated with dextrocardia and left aortic arch, and left thoracotomy in dextrocardia and right aortic arch. [ABSTRACT FROM AUTHOR]