AbstractA 10 month old male child was brought with history of fever, poor feeding, cough, regurgitation of feeds, and stridor. Child was initially treated as Acute laryngotracheobronchitis, but as he was not improving, was referred for further management. At admission child was irritable, nontoxic, afebrile, drooling of saliva and weak cry was noted, inspiratory and expiratory stridor with respiratory distress was noted. Investigations were suggestive of sepsis. Chest Xray showed resolving bilateral upper lobe pneumonia. As distress worsened, CT Neck and Thorax was done which revealed a retropharyngeal abscess. Child was then intubated and ventilated due to deteriorating clinical condition, and he was taken up for drainage of the abscess through transoral approach. He tolerated the procedure well and was treated with a full course of IV antibiotics as per culture report which grew Staphylococcus aureus. He was discharged in a stable condition. This highlights the need to closely investigate adeceptively simple upper airway obstruction as there may be a more serious underlying pathology such as a retropharyngeal abscess.