Introduction: Bilateral choanal atresia is a rare and potentially lethal congenital malformation in newborns. It represents a neonatal emergency. It causes posterior nasal obstruction, leading to neonatal respiratory distress. Computed tomography (CT) is the gold standard for confirming the diagnosis and planning surgical management. Case Presentation: We report three newborns presenting with respiratory distress of varying intensity from the first days of life. Clinical examinations suggested bilateral choanal atresia, which was confirmed by CT. The forms observed included pure bone atresia and two mixed forms, with notable anatomical variations such as thickening of the vomer (6.4 mm) and hypoplasia of the paranasal sinuses. Intervention and Follow-Up: The patients received initial medical care. Surgery was considered, but could not be performed urgently in all cases. Conclusion: CT plays an essential role in the accurate diagnosis, anatomical characterisation, and surgical planning of neonatal bilateral choanal atresia.
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