Negative pressure pulmonary edema (NPPE) is a danger-ous and potentially fatal condition with a multifactorial pathogenesis. NPPE is frequently a manifestation of upper airway obstruction, indeed the large negative intrathoracic pressure generated by forced inspiration against an obstructed airway is thought to be the main mechanism involved. The early detection of the signs of this syndrome is vital to the treatment and to patient outcome. The paper presents a case of NPPE due to post-extubation laryngospasm in a 14-year-old patient.