Aerodigestive fistulas are a condition that, if left uncorrected, portend a high risk of morbidity and mortality. This pathological condition may present as a congenital anomaly or as an acquired condition in adulthood. Its management varies greatly based on inherent fistula characteristics, patient’s clinical condition, and overall goals of care. Acquired aerodigestive fistulas may be subclassified as benign or malignant, with treatment modalities ranging from surgical interventions to numerous endoscopic procedures, including stent placement. Within this chapter, we discuss the classical approach to management of this highly morbid condition, as well as alternative and emerging therapeutic interventions that can be considered. Overall, a multidisciplinary approach is recommended to appropriately treat this condition.