Newborn oropharyngeal teratomas are extremely rare disorders. Epignathus tumour is a congenital malformation characterised as a 'mature teratoma' located at the oropharyngeal region. Teratomas in the upper respiratory airway give rise to abnormal life -threatening airway obstruction during the neonatal period. It is associated with high morbidity and mortality, requiring proper and cautious planning and prompt surgery. We describe a rare case of oropharyngeal teratoma in a premature male neonate (35 weeks gestation) who presented with difficult intubation. On flexible laryngoscopy, it appeared as a large vallecular cyst, while the computed tomography scan demonstrated a posterior pharyngeal wall cystic lesion causing oropharynx narrowing. The patient was operated on 8th day postpartum. Histopathological examination was compatible with mature cystic teratoma.