Macroglossia is defined as an enlarged tongue that in the resting position protrudes beyond the alveolar ridge or teeth. Macroglossia may be a chronic, indolent phenomenon or may be acute. We present a case of acute traumatic macroglossia in a pediatric patient following accidental self-application of an orthodontic elastic band. The 5-year-old patient presented with swelling of the anterior portion of the tongue unassociated with upper airway obstruction. The diagnosis was delayed until the patient was in the operating room under general anesthesia for repair of a presumed traumatic laceration, 3 weeks after her initial presentation. A thorough history may not reveal the cause of acute macroglossia. Examination under sedation may be necessary to establish a definitive diagnosis.
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