Background: Laryngomalacia is a congenital or, less commonly, acquired condition characterized by dynamic collapse of the supraglottic structures during inspiration. It is the leading cause of inspiratory stridor in infants, accounting for approximately 60%–75% of cases globally. The pathophysiology involves flaccid laryngeal tissues particularly the arytenoid cartilages, aryepiglottic folds, and epiglottis leading to airway obstruction when negative intrathoracic pressure increases during inhalation. The condition is generally classified as mild, moderate, or severe, based on symptom severity, impact on feeding and growth, and respiratory compromise. While the majority of mild cases resolve spontaneously by 18 to 24 months, more severe forms may result in significant complications including hypoxia, feeding difficulties, gastroesophageal reflux, failure to thrive, obstructive sleep apnea, and developmental delays. In such cases, conservative approaches like anti-reflux therapy and positional feeding may prove inadequate, necessitating surgical interventions such as supraglottoplasty or tracheostomy. In low-resource settings like Zanzibar, timely diagnosis and access to specialized surgical interventions are often limited. This increases the risk of progression from mild to life-threatening forms due to diagnostic delays, lack of equipment such as flexible laryngoscopes, and inadequate neonatal monitoring systems. Additionally, healthcare worker training in neonatal airway disorders is often insufficient in remote areas. This case report illustrates how prompt recognition, referral, and surgical management in such a setting led to a successful outcome, despite initial challenges.