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Background: The Airtraq™, a new disposable indirect laryngoscope, was evaluated in patients with difficult intubation. Methods: The Airtraq™ was used in 47 patients with predicted or unpredicted difficult intubation after failed orotracheal intubation performed by two senior anaesthesiologists with the Macintosh laryngoscope. Results: Tracheal intubation with Airtraq™ was successful in 36 patients (80%). The Cormack and Lehane score was IIb–III in 35 patients, and IV in 12 patients, with the Macintosh laryngoscope, while Cormack and Lehane score was I–IIa in 40 patients, IIb–III in three and IV in four with Airtraq™. A gum elastic bougie was used to facilitate tracheal access in one-third (11/36) of the cases. Orotracheal intubation was not possible with Airtraq™ in nine cases, five of whom had a pharyngeal, laryngeal or basal lingual tumour. Conclusion: In patients with difficult airway, following failed conventional orotracheal intubation, Airtraq™ allows securing the airway in 80% of cases mainly by improving glottis view. However, the Airtraq™ does not guarantee successful intubation in all instances, especially in case of laryngeal and/or pharyngeal obstruction. [ABSTRACT FROM AUTHOR]