Acute epiglottitis, a fulminating infection in the supraglottic tissue due to Haemophilus influenzae type B can cause relentlessly progressive airway obstruction in infants, children and sometimes in adults. Rapid infection and swelling of the epiglottis and aryepiglottic folds causes airway obstruction which can be relieved by endotracheal intubation. The systemic infection and septicaemia must be treated by the appropriate intravenous antibiotics. Acute epiglottitis must be differentiated from viral laryngotracheitis or "croup" which is very common and from pseudo-membranous bacterial tracheitis which is rare. A protocol for management of acute inflammatory airway obstruction must involve an orderly sequence of diagnostic and therapeutic measures, instituted without delay.