Topical phenylephrine is used in nasotracheal intubation to prevent nasal mucosal bleeding. The administration of topical phenylephrine can result in severe hypertension secondary to alpha-adrenergic stimulation. A high incidence of pulmonary edema is present in the patients given drugs with beta-blocking activity after phenylephrine administration. We report upon a pediatric patient in whom severe hypertension and pulmonary edema occured following the administration of topical phenylephrine.