In the past, anticholinergic agents were an inevitable premedicant in children as it reduces the oral secretions and bradycardia produced by anaesthetic agents. However, controlled studies evaluating their effects produced mixed results and gradually their use over the years has been declining. Presently, some of us still believe that anticholinergic agents are useful in children and continue to use glycopyrrolate as a premedication in almost all paediatric patients. Even with the controversies over the use of glycopyrrolate as a premedication, we have never looked seriously at the side effects of the anticholinergic drugs. The dry mouth caused by glycopyrrolate can be very uncomfortable for the patient, friable mucous membrane and inspissated secretions can be life threatening. We report a case of a four year old child undergoing choledochal cyst excision and hepaticojejunostomy with severe adverse respiratory event due to impacted inspissated secretions following glycopyrrolate premedication.