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Laryngeal granuloma is a benign inflammatory lesion that is formed by granulation tissue that occurs primarily in the vocal process of arytenoids cartilage. It possesses multifactorial etiologies, including laryngeal trauma, gastroesophageal reflux, and vocal abuse. Acute airway obstruction represents an unorthodox complication of post-intubation laryngeal granuloma. Apart from foisting a ball-valve effect, thereby occluding the luminal airflow, a laryngeal granuloma imposes an acrimonious challenge from the perspective of airway security. Therefore, a multidisciplinary approach with a deliberate difficulty airway algorithm is paramount in everting disastrous repercussions. We present a case of laryngeal granulomas on the right posterior vocal fold in a 33-year-old female. The tumour measures approximately 10mm and acts as a “one-way valve”, which rendered endotracheal intubation. An emergency tracheostomy and direct laryngoscopy were performed to excise the tumour in total. A thorough history and evaluation of airway assessment are essential in planning the best approach and management for the patient.