Functional disorders of the vocal cords can present with acute, dramatic upper airway obstruction, with features mimicking asthma or functional dysphonia. We report the case of an eighteen-year-old female with acute airway obstruction initially misdiagnosed as asthma. Laryngoscopy, bronchoscopy and psychiatric assessment confirmed a diagnosis of functional disorder of the vocal cords. Although a diagnosis of exclusion, it must be borne in mind in order to reduce unnecessary medical therapy and surgical intervention. It is only with the correct diagnosis that patients can receive appropriate therapy.