BACKGROUND: The article presents a case report of subacute epiglottitis in a healthy three-year-old child, secondary to Epstein-Barr Virus (EBV) infection. This case is particularly significant as EBV-related epiglottitis is extremely rare, with only one prior reported case in a pediatric patient. CASE PRESENTATION: A previously healthy three-year-old boy developed fever, cough, and difficulty breathing, initially diagnosed as croup but worsened, leading to hospital admission with respiratory distress, odynophagia and dysphagia. He had a hoarse voice, inspiratory stridor, swollen neck lymph nodes, increased work of breathing and hypoxemia, but was otherwise alert and nontoxic. Laboratory tests confirmed acute EBV infection, and imaging showed an enlarged epiglottis. The patient received supportive care, including oxygen therapy, and did not require intubation. CONCLUSIONS: The case highlights the importance of considering EBV as a potential cause of epiglottitis in pediatric patients.