Bifid epiglottis syndrome

True bifid epiglottis is an extremely rare laryngeal anomaly, which usually presents in the neonate with symptoms of aspiration and/or airway obstruction. Management is generally supportive observation as the symptoms lessen with age, but rarely tracheotomy is required for airway obstruction. Bifid epiglottis occurs in a syndromic picture with associated anomalies, especially polydactyly, cleft palate and retro/micrognathia but a significant number will have endocrine, gastrointestinal and genitourinary abnormalities. A case of true bifid epiglottis is presented and the literature is reviewed on the subject.