Neuroblastoma is the most common solid extracranial tumor in childhood, that arises from neural crest cells. The cervical location is the least frequent and its clinical manifestations are diverse, from cervical mass, dyspnea, stridor, Horner's syndrome or dysphagia. In this case report, we present a male infant with an atypical clinical symptoms, with upper airway obstruction that can occur in multiple contexts, whether malformative or neoplastic masses; Simple and contrast-enhanced neck tomography revealed a lesion in the right posterior cervical triangle with involvement in the retropharyngeal region and significant displacement of the airway. The tumor was successfully excised. The histopathological diagnosis was mixed ganglioneuroblastoma, rich in Schwannian stroma, treatment was started with the COG protocol with 4 cycles of chemotherapy, at the end a control MRI was performed without evidence of tumor recurrence. The importance of recognizing primary tumors with atypical signs and symptoms is highlighted, given that the frequency of neuroblastomas, statistically speaking, is the second cause of childhood cancer, early diagnosis must be made in order to achieve successful treatment.