Ludwig’s Angina (LA) is an uncommon but potentially fatal cellulitis of the submandibular space, complicated by contiguous spread of infection within the respiratory tract and acute airway obstruction. A 13 month-old female developed LA following upper respiratory tract infection with Parainfluenza-3 virus. There was rapid deterioration due to acute airway obstruction and emergency endoctracheal intubation was necessary. A literature review identified thirty-five paediatric cases of LA with a 14% mortality rate. It occurs predominantly in immunocompetent children with an odontogenic source of infection in a third and unknown source of infection in a third of cases. This is the first reported case of a child with preceding respiratory viral infection who developed LA and it is proposed that respiratory viruses may play a previously unrecognized role in the aetiology of Ludwig’s angina in children.