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Parapharyngeal abscess is a common deep space neck infection. However, bilateral parapharyngeal abscess is rarely found due to the protective function of neck fascia. In general, bilateral parapharyngeal abscess can cause various fatal complications but early diagnosis, targeted antimicrobial therapy and drainage of the abscess may reduce the risk of these complications and mortality. Here, we reported a case of a healthy man with bilateral parapharyngeal abscess complicated with an upper airway obstruction.