Radiation to the head and neck is commonly used in the treatment of cancers. A side effect in some patients is the development of pharyngeal and or esophageal strictures. Hypopharyngeal strictures can resemble edematous larynges. If mistakenly so identified, tracheal tubes placed through these structures are unlikely to result in tracheal intubation and more likely to cause obstruction, esophageal intubation or mediastinal damage. This report points out the development of hypopharyngeal stenosis following radiation. The location and appearance of hypopharyngeal stenosis during laryngoscopy are illustrated. The report points out the deficiencies of newer supraglotic laryngoscopes in this situation and underscores the benefits of flexible fiberoptic devices.