Purpose: Patients with oesophageal atresia and tracheoesophageal fistula (OA/TOF) undergo repair within the first days of life, and subsequently require frequent multidisciplinary follow up. For patients living in rural New Zealand, this poses both significant cost and time travelling away from home, which often continues throughout childhood. Methods: We conducted a retrospective study of all patients who underwent OA/TOF repair at Starship Hospital between 2008 and 2022. Follow up visits were quantified, with a specific focus on those residing in rural New Zealand. We analysed the impact of geographical location on care delivery and follow up timeframes. Results: The average follow up timeframe for rural patients (6.95 years) was comparable to that of Auckland region patients (6.84 years). However, rural patients had significantly fewer visits in the first year, with an average of 5.93 visits compared to 9.44 visits for urban patients. Despite the increased logistical challenges faced by rural patients, multidisciplinary follow up care was less frequent, with rural patients attending 1.27 combined visits in the first year compared to 1.44 for urban counterparts. Conclusion: While patients with OA/TOF living in rural New Zealand were followed up for a similar timeframe to those living in the Auckland region, they experienced fewer visits in the first year, highlighting the significant barriers posed by travel and access. This disparity underscores the need for improved healthcare support in rural regions. Our findings advocate for enhanced multidisciplinary care models, such as those provided by the Aerodigestive Clinic, which are particularly beneficial for rural patients facing logistical challenges in accessing care.