Anesthesiologists traditionally approach airway management and maintenance of a patent airway through translaryngeal techniques. Most of the techniques and devices routinely used in clinical practice (orotracheal intubation, nasotracheal intubation, laryngeal mask airway, Combitube, fiberoptic intubation, and so forth) maintain airway patency by way of manipulation of components of the upper airway. Successful maintenance of a patient airway involves a detailed understanding of the interaction of each device or technique with the structures of the upper airway. The goals of this article are to review the skills commensurate with successful recognition of airway problems and management of the patient with a known or suspected difficult airway.