Background. Upper airway obstruction in children due to severe allergic reactions can cause hypoxemia which can in turn lead to an acute life-threatening situation. In particular food-induced anaphylaxis is increasing and appears to be most prevalent in children under the age of 5 years. Children with asthma and an allergic disposition are at a higher risk of developing severe allergy and anaphylaxis. Symptoms. Stridor and dyspnea are the leading symptoms of upper airway obstruction in children. In cases of severe allergy, symptoms will develop suddenly after antigen exposure in otherwise healthy children. Other reasons for upper airway obstruction, such as infection, trauma and aspiration of foreign bodies into the pediatric airways should be excluded. Management. Cornerstones of treatment are airway protection, administration of oxygen and immediate admission to a pediatric hospital with doctor-accompanied transport. The administration of intramuscular adrenaline at 0.01 mg/kg body weight and the administration of continuous nebulized adrenaline are recommended as first line treatment.