Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease of viral etiology affecting most commonly larynx. A 5-year-old child with stridor was posted for microlaryngoscopic excision of laryngeal papilloma. We discuss the perioperative management of case with the various ventilation strategies. In child with stridor intubation remains the safest option. It is suggested to maintain spontaneous ventilation until intubation as mask ventilation could be difficult.