Acute epiglottitis may be more common in adults than is generally believed, but the diagnosis is often missed. Three cases of adults with epiglottitis are reported. The presenting signs and symptoms included sore throat, dysphagia, symptoms disproportionate to pharyngeal findings, and tenderness over the neck anteriorly. All three patients had a benign course, but acute upper airway obstruction can occur. The diagnosis was established in each case by mirror or flexible fiberoptic laryngoscopy, lateral neck radiographs, or both. Treatment consisted of maintenance of a patent airway and administration of humidified oxygen and antibiotics.