Ludwig’s angina is an infection of the neck and tongue floor soft tissues which compromises the airway, and implies a silent and fast progression of the cellulitis. Mainly described in children, it has shown a reduction of its incidence in the last decades because of the use of new antibiotics. For this reason doctors are not familiar with this pathology, causing diagnosis delay and ignorance of potentially fatal complications of this entity. We describe a case seen in the emergency room, emphasizing the new additional treatment tendencies to antibiotic therapy to reduce the risk of fatal complications and airway compromise.