The prevalence of asthma is sharply increasing in pediatric population and has become a global burden of medicine and economics. Nevertheless, evidence for the diagnostic criteria of this condition is still lacking. This condition leads to over-diagnosis of asthma in cases, especially younger children. Stridor and wheezing, pathologic signs of airway obstruction, are sometimes mistakenly identified. As a result, disorders of extra-thoracic airway obstruction may be misdiagnosed with intrathoracic diseases. An example of this confusion is that a 19-month girl admitted to our hospital with a diagnosis of uncontrolled asthma. Careful history taking, physical examinations and laboratory investigations revealed that the patient has laryngomalacia. We report this case in order to share with pediatric colleagues a valuable clinical experience in approaching children with noisy breathing.