Laryngeal tenderness is the leading cause of wheezing in infants and accounts for 50-70% of congenital laryngeal malformations. It was first suggested by Jackson in 1942. Laryngeal tenderness usually does not occur or is unnoticed at birth and typically appears days or weeks later as a high-pitched tone at the end of the respiratory period. The pathogenesis of laryngeal tenderness is unknown. Weakness of the laryngeal cartilage may be associated with malnutrition during pregnancy, or fetal calcium deficiency, or other micronutrient deficiencies. Children with mild laryngeal tenderness require only vitamin D and calcium supplementation or no treatment, and their symptoms resolve at 18 to 24 months. Children with severe laryngeal tenderness require surgery. What is severe laryngeal tenderness? Severe laryngeal tenderness is laryngeal tenderness that may interfere with normal breathing, feeding, or even threaten life. The symptoms may affect growth and development and may even lead to respiratory failure, such as cyanosis or dyspnea, feeding difficulties due to choking and coughing, and recurrent bronchopneumonia. Such children should be treated with surgical intervention.