The exact cause of TEF is unknown, but it is believed to result from a disruption in the normal development of the trachea and esophagus during fetal growth. Genetic factors and environmental influences may play a role. TEF can also be associated with other congenital disorders such as VACTERL association, which includes vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities.
