While mandibular distraction is an accepted method to treat respiratory disturbances due to Pierre Robin Syndrome, the indications does not remain clear at all. We present our experience in seven cases treated with unidirectional external mandibular distractors. All the patients were operated on the first week of life. There were 5 boys and 2 girls. All patients were operated under oral intubation, that was maintained until the distraction reached 5 mm and in a radiography we can see a satisfactory air shadow. We started the distraction on day 3, and carry it on until we got a contact border to border between the maxilla and mandible. Finished the distraction, the device was kept in place for 6 weeks. We had no postoperative complications but 3 patients needed tracheostomy, 2 due swallowing disorders with aspiration, 3 weeks and 1 month after distraction, and 1, during the distraction due to neurological disorders and mechanic ventilation needs. We try to establish the parameters to improve indications, and to avoid treatment failures.