Abstract: Acute epiglottitis (AE) is a potentially life?threatening infection of the supraglottic structures, which can lead to sudden, fatal airway obstruction,[1] may require urgent tracheal intubation or tracheotomy. However, there are no putative predictors for urgent airway intervention in AE, and the timing to establish an artificial airway for adult AE patients remains controversial.[1,2] Adult patients with diabetes mellitus might bear higher risk of airway compromise and patients who required airway support tend to have higher admission serum glucose level.[2] We report a case ofAE in an adult with diabetes mellitus, who developed sudden airway obstruction, and resulting in sudden cardiac arrest after failed tracheal intubation.