Negative pressure pulmonary edema (NPPE) or post obstructive pulmonary edema occurs due to forced inspiratory efforts against an obstructed airway. It is dangerous and life threatening if not promptly diagnosed and treated. Patients generate a high negative airway pressure and hydrostatic forces imbalance, which increases transvascular fluid infiltration and precipitates interstitial and alveolar edema. Recovery is rapid with adequate supportive measures, endotracheal intubation or cricothyroidectomy and oxygen. We have discussed about the steps on how to relieve laryngospasm, extubation, treatment and appropriate ventilator settings and investigations. We have focused on its early identification and management to prevent mortality and further complications which is informative for all anaesthesiologists.