Laryngeal papillomatosis is a rare and potentially severe cause of recurrent laryngeal dyspnea resistant to the usual treatments. It results from human papilloma virus (HPV) infection, transmitted M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o n during the perinatal period, and is mainly observed during the childhood. Upper airway obstruction is due to the growth of benign tumor, with rare malignant transformation. However, genetic mutation in association with viral integration can lead to the development and clonal expansion of malignant lesions. We report on one pediatric case of recurrent upper airway obstruction due to severe laryngeal papillomatosis with histological dysplasia. Through this case, the Authors emphasize the importance of early detection, close follow up, and appropriate treatment. They also call for increased HPV immunization coverage in low-income countries where medical resources are limited.IMPACT STATEMENT: Juvenile laryngeal papillomatosis is a rare but serious recurrent respiratory emergency with possible malignant transformation. Its management is challenging in low-income countries, and the HPV immunization is a promising measure.