When children develop acute laryngeal obstruction it is important to know promptly whether bronchoscopy and tracheotomy are called for. During a 14-year period 140 cases of acute laryngotracheobronchitis have been treated. Tracheotomy was found necessary in 28 cases. During 1958 steroid therapy was used in 13 cases of acute subglottic laryngitis and, in every case this obviated the need for tracheotomy. A case history illustrates the rapid improvement induced by hydrocortisone given by intravenous drip in infectious subglottic laryngitis in an atopic child. The history of a second case of subglottic laryngitis illustrates the extreme degree of crusting that can occur and the promptness of relief when crusts are removed by bronchoscopy and respiration is eased by tracheotomy. In the experience of the author prompt differential diagnosis, followed by modern methods of treatment, has been lifesaving in nearly every case of acute laryngeal obstruction in children.