In pediatric patients, the incidence of Sleep-Disorder breathing (SDB) is 2% for OSAS and 7-8% for snoring. Snoring, sleep apnea and the development of neurocognitive and behavioral disorders represent the main symptoms. In these children, snoring is noisy and is present for the greater part of sleep. Accurate diagnosis and treatment protocol is critical for a child with OSAS as it is associated to complications as: pulmonary hypertension, chronic pulmonary heart disease, low height-weight development, behavioral problems, reduced school performance, bedwetting and daytime sleepiness or irritability. For this reason, over the years different surgical techniques were developed to solve the clinical symptoms evident on the polysomnographic test. In this paper, the authors report the experience at the Department of Cranio-Maxillo-Facial Surgery, Policlinico Umberto I, “Sapienza” Università di Roma, in the treatment of pediatric patients with OSAS and midface retrusion.