Cervical teratomas are rare congenital tumours with potential for airway compromise and significant vascular involvement, posing a high risk of neonatal morbidity and mortality. This presentation details a case of cervical teratoma managed at a tertiary paediatric centre, highlighting the crucial role of multidisciplinary collaboration and advanced airway management techniques, specifically the ex-utero intrapartum treatment (EXIT) procedure, in achieving successful outcomes. A 28-year-old primigravida was referred at 20 weeks’ gestation with a foetal neck mass diagnosed as a cervical teratoma via ultrasonography and MRI. The lesion, originating from the right submandibular region, progressively enlarged, compressing the oropharynx and trachea. Despite the absence of foetal decompensation, a comprehensive prenatal management plan was developed by a team of maternal-foetal medicine specialists, paediatric surgeons, radiologists, and otolaryngologists. Given the high risk of airway obstruction at birth, an EXIT procedure was planned to secure the airway. At 37 weeks’ gestation, an emergency EXIT procedure was performed due to spontaneous labour. The neonate was successfully intubated, ensuring oxygenation and immediate transfer to the neonatal intensive care unit (NICU). Following angiogram, preoperative embolisation was performed to minimise haemorrhage risk. On day two of life, the tumour was excised. Postoperative challenges included transient vocal cord palsy and thyroid dysfunction. This case underscores the importance of antenatal diagnosis, advanced imaging, and a coordinated multidisciplinary approach for optimal management of cervical teratomas. The EXIT procedure proved instrumental in neonatal airway management, facilitating a safe surgical pathway. Long-term follow-up demonstrated favourable outcomes with the patient discharged with no airway support, reflecting the value of collaborative planning and comprehensive postnatal care in complex neonatal cases.