Of 27 children treated for acute epiglottitis, 26 survived. Eighteen patients treated by nasotracheal intubation were devoid of sequelae, whereas of six patients in whom tracheotomy was performed, one developed an ugly scar and two had slight tracheal stenosis at the tracheostomy site. In 22 of the 27 children the diagnosis of the referring physician was wrong, causing serious delay in securing the airway. We conclude that short-term nasotracheal intubation and antibiotic prophylaxis is the optimal treatment for acute epiglottitis in children. However, such patients are often in a critical condition, and it is essential that a well-planned procedure for examination and treatment is established in each hospital.