Introduction: A laryngocele is an abnormal dilatation of the laryngeal saccule. It is asymptomatic most of the time so its true incidence is unknown. Depending on the site, symptoms may vary from a lump sensation in the throat to breathing difficulty. Radiologic confirmation of the diagnosis is a must.

Report: A 50-year-old diabetic gentleman presenting with acute airway obstruction was evaluated and found to have an internal laryngopyocele which was managed with IV antibiotics and an endoscopic approach (draining and marsupialization) after securing the airway by tracheostomy. A review of the literature reveals that there is no consensus to manage such patients due to the rarity of the problem. The patient was decannulated in 5 days and made a good recovery.

Conclusion: We advocate an endoscopic approach for internal laryngopyocele in emergency situations as it can expedite recovery due to less morbidity when compared to an external approach.