The technics for early diagnosis and airway management of acute epiglottitis in children continue to provoke disagreement. In 104 cases of children with acute epiglottitis, early diagnosis was confirmed by cervical roentgenograms, direct pharyngoscopy, or both. Airway maintenance was provided by nasotracheal intubation of conscious patients in most cases. No tracheostomies were performed. Blood cultures obtained after, rather than before, nasotracheal instrumentation resulted in a significant increase in positive Haemophilus influenzae cultures.