A 20-year retrospective review of 236 children with epiglottitis was performed to determine the frequency of occurrence of 21 presenting signs and symptoms. To determine the association of age with clinical presentation and diagnosis of epiglottitis, the signs and symptoms of children less than 2 years old were compared with those of children 2 years of age and older. Fifty-eight children (25%) were less than 2 years old. Sore throat was the only factor significantly different in the two age groups (P less than .01), occurring more commonly in the older children. There were 128 children (54%) with blood cultures positive for Haemophilus influenzae. Analyses of patients with positive blood cultures gave similar results. The signs and symptoms that clinically support epiglottitis in children less than 2 years old are similar in older children.