Syndromic patients can present with severe mandibular retrognathia leading to Airway obstruction. Most of the patient's requires Tracheostomy but all these techniques are temporary and needs further care and management.Cortical osteotomy with minimum periosteal stripping should be done. Latency period of 3-7 days depending on surgical site. 1mm distraction per day. In neonates and children 2mm to 1.5mm can be carried per day. Distraction rhythm: continuous force application. Consolidation period should not be less than 6 weeks or should last till cortical outlines are seen on radiographs.This review clearly indicates that significant long term improvement can be achieved with distraction osteogenesis in such patient's.The complication rate is minimized and results are quite stable.