Objectives <p>To evaluate treatment strategies and identify prognostic factors associated with the treatment of congenital laryngeal webs in young children.</p> Methods <p>A retrospective review was conducted on 22 young children with congenital laryngeal webs treated at the Shanghai Children’s Hospital between January 2015 and June 2023. Demographic data, severity of the webs, treatment methods, number of surgical procedures and outcomes were systematically collected and analyzed.</p> Results <p>22 children (11males, 11females) were included in the study with a median age of 8.5 months. Based on Cohen classification, the degree of webs was type II in ten patients, type III in eleven patients and type IV in one patient. Subglottic involvement was observed in 12 cases. Eight patients showed a good outcome with 1–5 endoscopic surgeries while fourteen patients received further open surgery due to several failed endoscopic surgeries. All patients were finally treated successfully (decannulation or prevention of tracheostomy) with an average number of surgeries of three. The decision of open surgery introduced as remedial measures was dependent on subglottic involvement(<i>P</i> &lt; 0.05). Cohen classification together with age of operation was related to the number of surgical procedures (<i>P</i> &lt; 0.05).</p> Conclusion <p>Postoperative recurrence is a challenging risk in the treatment of congenital laryngeal webs in young children, especially for those with higher Cohen types and lower surgical age. Instead of endoscopic surgery, open surgery should be considered in case of involvement of the subglottic area.</p> <p><b>Level of evidence</b>: 4</p>