Pediatric airway problem is usually a life-threatening event for children and always a challenge for pediatric otolaryngologist. Since the modern advancement in medical and optical instrumentation with high resolution video system, endoscopy has become an absolutely necessary technique and requirement for the sub-specialty in pediatric otorhinolaryngology.
　　Endoscopic techniques for evaluation and management of airway in pediatric patients have matured greatly in the past decade, especially with the introduction of Laser, microdebrider, coblator, dilator, balloon dilatation, stenting instrumentation, and topical medication or tissue fibrin glue application. For example, to treat severe laryngomalacia, subglottic hemangioma, laryngeal papillomatosis, granuloma or web, subglottic or tracheal stenosis, bilateral vocal fold paralysis, tracheobronchial tumor, congenital fistula etc. were all effective in selective cases.
　　These developments have been proved that pediatric endoscopic techniques can be performed in the airway safely and effectively when a team approach is well collaborate. The appropriate choice of accessary instruments or devices, professional pediatric anesthesia access, post-operation intensive cares, cooperation and understanding of families were all essential factors for a successful endoscopic surgery in pediatric airway management.
With recent advancement in optic instrumentation and endoscopic techniques, therapeutic interventional endoscopic surgery has replaced some traditional surgical techniques and become the primary option for pediatric airway management during the modern practices of pediatric otolaryngology. Successfully coupling accessary instruments to an endoscope represented a logical extension of the clinical application of the modern medical techniques. Using this modality, a pediatric otolaryngologist takes advantages of endoscopic access, precise tissue vaporization, better hemostasis, minimal local inflammation with relatively painless and less subsequent edema of the narrow airway.
　　Therefore, in conclusion, pediatric airway endoscopic technique is not only confined to clinical diagnosis, but also may treat successfully in certain airway diseases and to avoid performing tracheotomy in children.