Lower airway obstruction is sometimes caused by the sudden closure of the vocal cords. This is termed laryngospasm. Laryngospasm is a protective reflex whose purpose is to prevent aspiration. However, the reflex may be exaggerated during light planes of anaesthesia, when it may become a cause of airway obstruction. This can occur in response to airway stimulation, blood or secretions in the airway, or aspiration.

Lower airway obstruction can also be caused by a physical obstruction to the larynx or trachea, such as a foreign body.

Bronchospasm is a potential cause of lower airway obstruction. It is likely to be associated with wheeze, unless it is very severe, when the chest may be silent.