Retropharyngeal abscess (RPA) is a rare entity in infants. There is limited knowledge and literature available about RPA in neonates and young infants owing to its atypical presentation, often causing a diagnostic dilemma to the treating physicians. RPA should always be kept in mind for all infants presenting with upper respiratory tract symptoms. Proper history, meticulous clinical examination and a very high index of suspicion is key to its prompt diagnosis. There is always a risk of airway compromise in neonates and young infants, owing to the narrow airway and an early surgical intervention is mandatory. We hereby present a rare case of RPA in a 35 day old male infant having atypical presentation of stridor and sepsis. Timely radiological evaluation in form of ultrasonography (USG) & contrast enhanced computerized tomography (CECT) neck was instrumental not only in prompt diagnosis but also in immediate decompression drainage of abscess which turned out to be lifesaving.
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