We experienced a case of inadvertent partial removal of vdegrees Cal polyp which was expelled through the tube after awake endotracheal intubation with stylet under direct laryngoscopy. The patient was a 73-years-old female suffering from dyspnea on exertion for 5 days and diagnosed bilateral vdegrees Cal polyps which were nearly obstructed vdegrees Cal cords. Awake endotracheal intubation was planned for her operation after preoperative conference with surgeons because she did not want tracheostomy. After topical anesthesia with 4% liddegrees Caine spray on oropharynx and injected midazolam intravenously, endotracheal tube with stylet under direct laryngoscopy was inserted with ease. But immediately after removal of the stylet, coughing was developed and a part of polyp was expelled through the tube. So, it might be suggested that tracheal reflex should be preserved when the patient refused tracheostomy and injury of lesion was worried by any kinds of awake intubation techniques.