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Background  Teratoma is a tumor derived from fetal germ cells with aberrant differentiation. Case Description  A 3-month-old infant with a mediastinal tumor was referred to our heart center. She presented with progressive dyspnea, cyanosis, and the need to be manually ventilated. The computed tomography scan displayed a huge tumor restricting the distal trachea including the bifurcation. An emergent operation was performed and the tumor was completely removed. Histological examination confirmed a mature teratoma. Conclusion  In such life-threatening situation, the early detection and the immediate operation are very important for the management of rapidly-progressing mediastinal teratomas compressing the respiratory tract., Competing Interests: Conflict of Interest There is no conflict exists. Author Nicole Piber declares that she has no conflict of interest. Author Wilko Weichert declares that he has no conflict of interest. Author Jürgen Hörer declares that he has no conflict of interest. Author Masamichi Ono declares that he has no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)