Subglottic airway obstruction in adults is rare and is often attributed to post-intubation or post-tracheostomy stenosis. Cricoid cartilage abscess is exceptionally uncommon and poses significant diagnostic challenges due to overlapping clinical and endoscopic features. A 45-year-old diabetic male developed progressive dyspnea and hoarseness following tracheostomy for Ludwig’s angina. Initial endoscopic evaluation suggested subglottic stenosis; however, contrast-enhanced computed tomography revealed a cricoid cartilage abscess causing critical airway narrowing. The patient was managed with elective tracheostomy, external surgical drainage of the abscess, and intravenous antibiotics, resulting in complete resolution of the lesion and successful decannulation. Cricoid cartilage abscess is a rare cause of subglottic airway obstruction and may clinically and endoscopically mimic subglottic stenosis. Contrast-enhanced computed tomography is valuable for establishing the diagnosis and delineating the extent of the abscess. Early imaging and timely surgical intervention, combined with appropriate antibiotic therapy, are crucial to prevent progressive airway compromise and achieve successful airway restoration.
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