The objective of this study was to audit the management of acute laryngo-tracheo-bronchitis in a paediatric unit. This was achieved by retrospective case note audit and a review of the investigations and management of all admitted patients in light of the current literature. There was inappropriate use of radiography and outmoded therapies. There has been an increasing use of adrenaline and steroids in the past 4 years. Prescribing of adrenaline was lax and was associated with potential danger to the patient. For a common condition such as croup, an agreed protocol taking into account current published recommendations is warranted and has been introduced into this unit following this audit.