Lingual tonsillar hypertrophy is an unusual presentation of voice change. If managed incorrectly this group of patients has the potential to deteriorate significantly causing airway obstruction and potentially death. We present a 68‐year‐old female spoken the ENT outpatient department with a several year history of altered speech that was deteriorating. On direct questioning it became apparent that she was laid low with “hot‐potato” speech. She failed to complain of any throat pain, dysphagia, weight loss, or breathing difficulties. Her past medical record was unremarkable aside from rheumatism that had been in check with long‐term methotrexate. an intensive ENT examination was performed. Significant lingual tonsillar hypertrophy was revealed as pictured (Figure (Figure1).1). This was so extensive it obscured visualization of the larynx on flexible nasolaryngoscopy. to permit a proper diagnosis and since of great airway concerns, the patient underwent surgical excision of her lingual tonsils. Histopathology of the lesion was benign with features keep with lymphoid hyperplasia.