PURPOSE: We sought to create and validate a high fidelity, anatomically correct real tissue simulation model for thoracoscopic esophageal atresia/tracheoesophageal fistula (EA/TEF) repair. METHODS: A scale reproduction of a neonatal rib cage was created. Surgically modified (EA/TEF) fetal bovine tissue completed the simulator. Nine pediatric surgery fellows and two attending pediatric surgeons (n=11) performed the simulated thoracoscopic EA/TEF repair. Participants completed a self-report rating scale, ranging from 1 (Don't know) to 5 (Highly realistic). Construct validity relevant to test content was evaluated by examining the ratings using the many-Facet Rasch model. RESULTS: Analyses indicated no differences when comparing faculty (Observed Average (OA)=4.5/5.0) to fellow (OA=3.3) ratings, p=.71. In descending order, observed averages of the domains were 4.7 (Relevance), 4.5 (Physical attributes), 4.5 (Realism of materials), 4.4 (Ability to perform task), and 4.2 (Value). The observed Global opinion rating indicated the simulator can be considered for teaching thoracoscopic EA/TEF repair but could be improved slightly. CONCLUSIONS: Fellow and faculty ratings indicated the simulator was valuable as a learning tool with minor modifications. Comments were consistent with high physical attribute ratings.