The incidence of difficult laryngoscopy or intubation varies from 1.5% to 13%, and failed intubation has been identified as one of the anesthesia-related causes of death or permanent brain damage. The Intubating Laryngeal Mask Airway (ILMA) is a new modified laryngeal mask with the capability for guided tracheal intubation while maintaining ventilation. The ILMA was designed by Brain to improve blind endotracheal intubation through a laryngeal mask. We report the successful use of this device in two patients with difficult airway during induction of general anesthesia.