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A male newborn presented with immediate neonatal respiratory distress and severe stridor requiring a high-flow nasal cannula. He was a full-term baby weighing 3090 g with no significant antenatal history. Nasolaryngoscopy revealed a cystic mass on the right side of the larynx (figure 1A). CT showed a well-circumscribed mass measuring 15 mm obstructing the glottis (figure 1B shows a sagittal view, figure 1C a coronal view). Neonatal laryngocele is an extremely rare condition characterised by a cystic dilatation of the laryngeal saccule, containing air or fluid.1 Although a benign lesion, laryngocele can cause severe airway obstruction requiring urgent intervention.2 Neonatal respiratory distress associated with stridor should alert neonatologists about a congenital airway abnormality and should require urgent specialist evaluation and laryngoscopy. In this case, laryngoscopy with cystic puncture was performed 2 days after birth. 12 days later, a recurrence of respiratory distress occurred, confirmed by MRI. A complete surgical removal under general anaesthesia was performed, and the infant is doing well without recurrence at 3 months of age.