Laryngeal leech infestation is a rare cause of upper air way obstruction in children. A high index of clinical suspicion of laryngeal leech infestation has to made in child presented with foreign body sensation in the aerodigestive tract, symptoms and signs suggestive of upper air way obstruction especially in areas where drinking water from the streams and ponds is a habit. Here, we report a 9-year-old male child who presented with signs of upper air way obstruction: coughing, shortness of breath, stridor and use of accessory muscles. Direct laryngoscope examination showed a visible black mobile leech through the anterior glottis area having attachment at the anterior commissure and the other at the anterior subglottic area occupying around 75% of glottic opening. The leech adhered to the larynx was grasped cautiously with laryngeal forceps and the leech removed alive. The patient was transferred to ward with stable vital signs. Subsequently patient was decannulated and discharged home.