In radiology, the steeple sign is a sign on a frontal X-ray of tracheal narrowing and suggestive of the diagnosis of croup.^[1]

• The steeple sign is seen on anteroposterior radiographs of the soft tissues of the neck.
  • Normal lateral convexities of the subglottic trachea are lost, and narrowing of the subglottic lumen produces an inverted V configuration in this area.
  • Point of the inverted V is at the level of the inferior margin of the true vocal cords.
  • Narrowing of the subglottic lumen alters the radiographic appearance of the tracheal air column, which resembles a steeply pitched roof or a church steeple.
• The lateral radiograph of the upper airway will show a normal epiglottis and narrowing of the subglottic region.

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