We have successfully treated 18 months old male for lateral pharyngeal abscess, mediastinal abscess and pyothorax both following retropharyngeal space abscess of staphylococcus aureus. Retropharyngeal space abscess is different from prevertebral space abscess in pathogenesis and clinical course. Antibiotics have markedly decreased the incidence of retropharyngeal space abscess, made the diagnosis more difficult because of their masking effect on the classical signs and caused a significant change in the character of deep neck infections. The surgeon must be ever on the alert to these problems and must not allow himself to fall lax with subsequent dire consequences. Possible complications of retropharyngeal space abscess are : mediastinitis, thrombosis of the internal jugular vein, aspiration pneumonia, asphyxia erosion of the carotid artery followed by a possible rupture of the artery and septicemia. We cannot rely entirely on medical therapy but sound surgical therapy based on applied anatomy is now more important than ever.