Gastroesophageal reflux (GER) is a common condition in preterm infants and has been implicated in the development of apnea, although the relationship between the two remains unclear. We report a 29-week gestation male infant who experienced an apnea episode associated with reflux of gastric contents into the cervical esophagus, as identified by multichannel intraluminal impedance-pH monitoring (MII-pH). MII-pH revealed that the apnea episode occurred during a GER event involving prolonged reflux into the cervical esophagus. Interventions, including body positioning, pharmacologic treatments, and dietary adjustments, successfully reduced the frequency of apnea and eliminated episodes of prolonged reflux into the cervical esophagus. This case highlights the utility of MII-pH in identifying reflux characteristics and their potential association with apnea, providing valuable insights for managing similar conditions in preterm infants.