Laryngeal cleft is a rare disease. The manifestation of the disease and its management vary depending on the severity of the cleft. Laryngeal cleft should be considered in the differential diagnosis, especially in neonates presenting with stridor and recurrent aspiration. The outcomes in patients with laryngeal cleft have improved significantly over the years due to increased awareness of the disease, early detection, good intensive care and advancement in surgical techniques. We present a unique case of laryngeal cleft type IV. To the best of our knowledge, there is no reported case in the author’s country, Malaysia.