Background. Glossoptosis is a dangerous but often overlooked cause of upper airway obstruction in infants. An operation may be necessary in serious cases. Two operative methods are available: tracheostomy and glossopexy. Tracheostomy guarantees a definite solution for the airway obstruction, but is known to have a considerable morbidity and mortality risk. In contrast, the effectiveness of glossopexy is often judged to be uncertain. We present our experience with glossopexy procedures and discuss the prerequisites for successful therapy. Method and patients. Between 1997 and 2002 we conducted five glossopexy procedures in infants with glossoptosis. In all patients a standardized airway under spontaneous respiration was conducted before operation. For glossopexy a modification of the technique by Randall was used. Results. In all patients airway obstruction disappeared directly after operation. No intra- or postoperative complications and no delays in swallowing or speech development were observed. Discussion. We therefore recommend glossopexy as the treatment of first choice for patients with severe true glossoptosis.