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Objectives: Bifid epiglottis is a rare laryngeal anomaly that confers an increased risk of aspiration and respiratory compromise. We present the surgical technique and perioperative management of a child with bifid epiglottis and chronic aspiration in the setting of Pallister-Hall Syndrome. Case report: A 2-month-old male presented to the pediatric otolaryngology clinic with dysphagia and congenital anomalies associated with Pallister-Hall syndrome. Flexible laryngoscopy revealed a wide, complete epiglottic cleft. He demonstrated chronic aspiration and significant failure to thrive. The epiglottis was endoscopically reconstructed. The perioperative course of postoperative care is detailed. Follow-up laryngoscopy showed continued integrity of the epiglottis. Conclusions: Aspiration associated with bifid epiglottis can be managed successfully with endoscopic techniques. Special consideration must be given toward synchronous airway anomalies, including those secondary to surgical repair. Keywords: Bifid epiglottis, Pallister-Hall syndrome, Aspiration, Laryngoplasty