Seventy-five patient-episodes of adult epiglottitis were analyzed retrospectively. Six tracheotomies were performed, and no deaths occurred. In a large subset of patients, viral pathogenesis was suggested by benign clinical courses that included normal or mildly elevated temperatures and minimally elevated leukocyte counts with relative lymphocytosis. Hospitalization may not be indicated for adults with epiglottitis of viral etiology as it is for patients with signs of bacterial infections.