To determine the role of Dexamethasone (DEX) in postextubation stridor (PS) frequency and reintubation rate in critically ill infants and children. This study was conducted in a pediatric intensive care unit of a university hospital. This was a retrospective case-control study. All children aged from 4 weeks to <5 year, were intubated for at least 48 hours [n=51] during 6 months. Data of the patients treated with DEX (0.5 ml/kg every 6 hours for 3 doses, beginning 6-12 hours prior to extubation) (n=30) were compared with control patients (who had not received medication) (n=21). The DEX and control groups were similar in age i.e., mean ages of DEX group were 16.85±14 months, and that of control group were 19.02 ± 19 months, mean duration of intubation and mechanical ventilation in DEX group was 5.17 ± 4.58 days, and that in control group was 3.98 ± 3.60 days. There was no significant difference between DEX and control group in the incidence of postextubation stridor [17% (5/30) vs. 10% (2/21); p = 0.5] and the reintubation rate [7% (2/30) vs. 10% (2/21); p = 0.7]. Our data revealed that the prophylactic use of dexamethasone in planned extubation of high risk children were not effective.