Abstract: Teratoma is a most common extra gonadal germ cell tumour of perinatal or neonatal period , but teratomas of nasopharynx and intra oral are rare in neonates . naso pharyngeal teratoma is a serious condition leading to the respiratory distress in newborn. In present case one day old female newborn female born to a 22 year healthy female by normal vaginal delivery with uneventful antenatal period with intra oral and nasopharyngeal growth protruding from the oral cavity leading to severe respiratory distress. Baby was managed immediately and MRI of head and neck suggested nasopharyngeal mass lesion with left intratemporal and left intra cranial extension suggesting solid cystic , calcified fat components of teratoma. Baby was resuscitated and growth was excised successfully and cleft palate was repaired and patient was discharged on normal bladder and bowel habits. Histopathological examination specimen suggested intraoral and nasopharyngeal benign teratoma. We present the intraoperative and specimen finding and treatment followed in this case.