We reported the case of a 12-year-old girl who was scheduled for elective tonsillectomy under general anesthesia. An aspiration episode occurred during the induction of anesthesia prior to tracheal intubation. Respiratory distress with hypoxemia developed rapidly. Emergency interventions including respiratory tract suctioning, tracheal intubation and bronchoscopy were performed in the operating room. Three hours after presentation, the radiological abnormalities resolved, and the clinical features improved as well. She was weaned from the ventilator during the following 1 hour. Six days after the episode, she was discharged from the hospital without detectable sequelae. The brief course of her respiratory distress differed from that reported previously. We describe this uncommon event and discuss the role of bronchoscopy in a gastric acid aspiration episode such as this.