Adult-type rhabdomyoma is a rare benign mesenchymal tumor seen in adults that becomes symptomatic after a long period of slow growth. It almost always originates from tissues of the head and neck containing striated muscle. The symptoms of rhabdomyoma include dysphagia, hoarseness, and globus. This report presents the case of a 60-year-old woman with isolated adult-type rhabdomyoma of the piriform sinus who presented with dyspnea and difficult tracheal intubation. The report emphasizes the importance of evaluating patients with upper airway obstruction for laryngeal masses before intubation