Failure to secure a clear airway can be fatal. Historically, a report of a closed claim analysis related to anesthesia practice during 1975–1984 indicated that adverse outcomes involving the respiratory system had comprised the single largest class of injury, and that the incidence of death or permanent brain damage associated with airway management was strikingly much higher (85%) than the incidence associated with cardiovascular management (30%). Since then, several major efforts have been made: several major guidelines have been made and updated for difficult airway management; routine use of a capnograph and a pulse oximeter has reduced the incidence of unrecognized esophageal intubation; the laryngeal mask airways or videolaryngoscopes have certainly reduced the incidence of difficult airway management. Because of these efforts, the incidence of serious complications is likely to have decreased. Nevertheless, the current strategies for difficult airway management are still not idea. I will point out what would be potential difficulties with airway management, and possible solutions to these problems.