We present a rare case of a cystic posterior pharyngeal wall mass in a 5 year old child in whom prior surgery without biopsy led to considerable delay in both diagnosis and definitive treatment. The child presented with recurrent aspiration pneumonia, dysphagia and obstructed breathing from birth. Transoral wide excisional biopsy established the diagnosis of foregut duplication cyst. Only seven reported cases have been described in the English language literature till date