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Emergency tracheostomy for failed intubation due to glottic stenosis. Glottic stenosis can be an unexpected finding during an intubation, causing difficulties that may result in a 'can't intubate, can't ventilate' situation. We present a case of a patient who required an emergency tracheostomy, in the setting of a failed intubation secondary to glottic stenosis. The patient underwent open laryngotracheal reconstruction, followed by tracheostomy decannulation 2 months post-surgery. This paper highlights the importance of awareness of laryngeal pathology masquerading as respiratory conditions. It also outlines the critical approach to managing 'can't intubate, can't ventilate' situations.