Purpose: Paediatric retropharyngeal infections can be associated with significant morbidity including airway compromise. Treatment can include medical management with intravenous antibiotics and steroids, as well surgical management. The aim of this study was to analyse the management of retropharyngeal infections within a tertiary paediatric centre. Methodology: Retrospective analysis of consecutive patients presenting to Starship Hospital from 1/1/15-1/1/23 with retropharyngeal infections. Data was collected from online medical records. Results: 73 patients were included in this study (mean age = 4.3 years). Diagnosis was made by clinical examination and imaging. All patients had at least 1 form of imaging. 17 had lateral neck X-rays alone, 10 patients had computed tomography (CT) alone, 46 patients had both lateral neck X-rays and further imaging including CT and Magnetic Resonance Imaging (MRI) neck. 73% of patients admitted with retropharyngeal infections underwent CT imaging. 40 patients were managed medically with intravenous antibiotics and intravenous steroids. 33 patients had surgical intervention with incision and drainage of an abscess during their admission. Of those patients, 6 (18%) required intubation and ICU admission post operatively and 1 (3%) patient returned to theatre for further surgical intervention. Mean duration of hospital stay in patients who were managed medically was 3.2 days compared to 6.33 days in patients who had surgical intervention. Conclusion: Retropharyngeal infections can be managed both medically and surgically. In this study, surgical management was usually carried out after failed medical management or in clinically more advanced disease.