The practice of securing the endotracheal tube with adhesive tape appears to be benign. However, evidence-based research suggests it is a high-risk practice. Common elements for the taping practice include the tape, anesthesia gas machine, and anesthesia provider. Researchers have found that adhesive tape outside its original packaging became contaminated with pathogens. The bacteria found on the tape included Pseudomonas, Escherichia coli, Klebsiella, Enterobacter, coagulase-positive staphylococci, methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcal organisms. In addition, a patient does not need to have direct contact with the anesthesia gas machine for pathogen transmission to occur. Anesthesia providers were identified as the origin of bacterial transmission in 12% of cases, with pathogens on their hands 66% of the time. Unfortunately, anesthesia providers are often noncompliant with hand hygiene. They failed to practice hand hygiene 82% of the time. Last, the tape can drop to the floor and harbor pathogens despite cleaning 41.6% of the time; it is often retrieved and reused. All the common elements, independently and collectively, involve the tape and its potential to increase the patient's exposure to pathogens and the risk of infection. This literature review presents evidence-based research regarding endotracheal tube taping practice to ensure patient safety.