Background: Robin sequence (RS) is a congenital disorder resulting in upper airway obstruction (UAO) of variable severity, with no current consensus about best-practice management. We aimed to identify differences in outcomes of infants with RS according to how UAO was treated. Methods: 13-month surveillance study; a monthly reporting card was distributed to 3500 paediatricians and all cleft teams, with data collection at initial report and at median age 2 years. Results: Of 173 infants with RS, 74% required an airway adjunct (AA); nasopharyngeal airway (NPA) 57%, CPAP 25%, ETT 15%, tracheostomy 12%, multiple AA types 30%. 29% were discharged with NPA for median 5 months. 9 infants had NPA inserted aged >4 weeks (late NPA), including 6 after discharge. Non-isolated RS was more common in infants with tracheostomy (68%) than those discharged with NPA (42%) or no AA (36%). 7 infants died at median 43 days old; 86% required AA, 43% had a tracheostomy, all had non-isolated RS. Infants discharged with NPA had a longer duration of NG feeds than those with no AA (5 months vs 2 months) and were less likely to be orally fed at f/u (84% vs 98%). Less than half with tracheostomy were orally fed at f/u. Developmental delay (DD) was more common with tracheostomy (47%) than discharge with NPA (20%), late NPA (22%) or no AA (27%). DD was least common in isolated RS (15%). Conclusion: UAO requiring AA in RS is common and may be late in onset, with close f/u required post-hospital discharge. RS infants who required tracheostomy had higher mortality, delayed oral feeding and higher DD incidence. This likely reflects a more severe RS phenotype with increased rate of non-isolated RS.