Case Report: Herein, we presented a rare case of a 4-year-old child, who had been diagnosed with a complete bilateral second arch branchial fistula. The excision was made using the bilateral stepladder approach and tonsillectomy.
Conclusion: The bilateral stepladder approach was a feasible method in excising a complete bilateral branchial fistula. However, larger-scale studies should be conducted on the surgical techniques of bilateral branchial fistulae excision in order to optimize the cosmetic outcome of the surgery.