A 13-year-old girl and a 12-year-old boy developed acute respiratory insufficiency caused by an upper airway obstruction, which necessitated intubation and mechanical ventilation. Cultures from throat swabs from the girl and boy yielded Haemophilus parainfluenzae and Streptococcus pneumoniae, respectively. Diagnoses of bacterial tracheitis were confirmed by tracheoscopy and both children were treated with antibiotics. After 11 and 4 days of mechanical ventilation, respectively, they were successfully extubated. No further complications were encountered. Bacterial tracheitis is a rare but significant cause of upper airway obstruction in children.