The oral and maxillofacial surgeon faces many situations in which maintenance of the patient's airway can be a problem. Facial trauma, severe infection, and trismus all can compromise the airway and pose a dangerous situation. The use of high-frequency jet ventilation (HFJV) via transtracheal puncture offers excellent airway protection with minimal patients discomfort prior to induction of anesthesia. The use of a large, cuffed endotracheal tube for blind awake nasal intubation, or in conjunction with tracheostomy, can be eliminated in many situations. HFJV offers minimal trauma to nasal passages and larynx while preventing aspiration. During emergence, discomfort is reduced to a minimum, and the patient can communicate verbally. These same advantages apply to patients who receive outpatient oral surgery. Therefore, in the choice of an anesthetic technique, HFJV should be a definite consideration.