The aim of this paper is to report the use of distraction osteogenesis to lengthening the mandible in order to improve the respiration on the children with severe upper airway obstruction. To patients included presented severe micrognatia showing least 3 symptoms of airway obstruction, being selected a group of 9 children. The ages had an average of 4.3 years old. Five patients required tracheostomy to release airway obstruction. The average oxygen saturation was 74% ranging from 58 to 86%. All the patients were submitted, to intra oral distraction osteogenesis. The patients were evaluated by pulse oximetry, endoscopic examination and mandibular growth. All of the patients submitted to distraction osteogenesis showed an improvement on their breathing conditions elevating the average oxygen saturation to an average 93% ranging from 86 to 96%. On the trachestomized group, four patients were successfully decannulated after the mandibular advancement. One patient the decannulation could not be performed due to the presence of traqueomalacia. With a follow up of 86 months (ranging from 32 to 86 months) no relapse was recorded on the oxygen saturation, however two relapses were recorded. The application of distraction osteogenesis showed excellent results, stability with low morbidity.