Upper airway dyspnea represents a challenge in diagnosis and management regardless of etiology. The emergency physician must work through a wide differential diagnosis. The most common causes are inflammatory, immunoallergic and infectious. Initial treatment includes maintenance of a safe and open airway, oxygen therapy, aerosolized epinephrine and steroid injections. Once the patient is stabilized, a detailed case history and a complete status are compulsory to guide diagnosis and adapt the treatment. Close collaboration between emergency physician, anesthesiologist and ENT specialist is mandatory.