Bilateral vocal cord paralysis being misdiagnosed as bronchial asthma has been reported in the literature on several occasions. Diagnosing this condition needs precise clinical acumen which could lead us to make an integrated diagnostic and treatment plan. Here. we report another missed case of bilateral vocal cord paralysis and the root cause analysis of the incident. https://www.lightemupsequences.com/hot-mega-Esko-Nexus-HeightMaster-Vented-Safety-Helmet-big-savings/