Sir,Laryngospasm is a common airway related complication in routine anesthetic practice. It is characterized by persistent spasmodic closure of larynx.[1] Persistent refractory complete laryngospasm during emergence after removal of an airway device is challenging to diagnose and treat.[2] A 58-year-old male weighing 62 kg with no known comorbidities was scheduled for tendon repair of index finger under general anesthesia using ProSeal laryngeal mask airway (PLMA). He was kept fasting for solids 12 h and 3 h for clear liquids. Tab. ranitidine 150 mg and tab. metoclopromide 10 mg was given night before and the day of surgery. Intravenous ramosetron 0.3 mg was given. At the end of procedure, Ryle's tube was suctioned via drain tube and removed noting no obvious gastric contents. At this time partial laryngospasm was noted as patient breathing spontaneously till now suddenly developed noisy breathing and loss of capnography trace. In view of PLMA being a predisposing factor for undesired airway stimulation under lighter plane of anesthesia, it was quickly removed. Patient continued to be assisted with 100% oxygen and gentle CPAP of 20 cm H2O. Within 60 s chest was seen expanding again coinciding well with reservoir bag movement and return of capnography trace. However, partial laryngospasm returned with a noisy breathing and progressed to complete laryngospasm. Upper airway obstruction was ruled out as a lubricated nasopharyngeal airway was gently inserted and showed only minimal secretions on suctioning. Once the patient became more awake, he had a sudden bout of vigorous cough and patient coughed out unidentifiable material into the face mask which immediately relieved the spasm. Closer examination revealed it was an unsuspecting food particle (intact skin of a red chilly) which he probably regurgitated and was causing recurrent laryngospasm.Identifying the possible cause of laryngospasm correctly is challenging.[3] General anesthesia predisposes to gastric regurgitation and aspiration. The use of a supraglottic airway device and spontaneous ventilation dose not completely secure the airway.The technique of draining the stomach via a Ryle's tube in a PLMA may not clear larger food particles from the stomach. Also a PLMA is associated with variable amount of gastric insufflation.[4] In our case regurgitation may have occurred at the end of procedure, in a lighter plane of anesthesia. Presence of a nasogastric tube in situ itself may act as a stimulant for regurgitation since lower esophageal sphincter remains patent. Laryngospasm was refractory to treatment. Only on return of cough reflex was the patient able to expel the food material which is the likely culprit of recurrent laryngospasm. The likelihood of regurgitation is high even in an adequately fasting patient. Laryngospasm may often be an early feature of pulmonary aspiration. A history of gastroesophageal reflux may indicate more chances of developing laryngospasm under general anesthesia. Thus, in presence of recurrent intractable laryngospasm; the possibility of regurgitant food particles persistently irritating the larynx should be thought of early.