BACKGROUND: The intubating laryngeal mask airway (ILMA) was introduced recently as an effective ventilatory device and intubation guide. The following study was designed to assess not only efficacy but also safety of the ILMA. METHODS: Sixty adult patients who were randomly assigned in 3 groups (Group 1, 2, 3), ASA class 1 or 2, undergoing elective surgery were induced with intravenous injection of fentanyl, thiopental sodium, vecuronium, lidocaine and inhalation of O2, N2O, enflurane. In Group 1 (n=20), the patients were intubated with Macintosh curved blade and endotracheal tube. In Group 2 (n=20), blind tracheal intubation using an ILMA was attempted. In Group 3 (n=20), we applicated the ILMA to a fiberoptic bronchoscope-aided tracheal intubation. Then we decided success rates for blind and fiberoptic-guided passage of an endotracheal tube via the ILMA. We measured systolic, diastolic arterial pressure and heart rate before administration of induction agent, 1 and 5 minutes after induction, just after intubation, 1, 2, 3 and 5 minutes after endotracheal intubation. RESULTS: The success rates for blind (Group 2) and fiberoptic-guided (Group 3) passage of an endotracheal tube via the ILMA were 70% and 100% respectively. There were no statistically significance in the systolic, diastolic arterial pressure and heart rate when compared to value of any other groups at any time but higher in all groups when compared to preinduction value of each group just after intubation. CONCLUSIONS: Though the ILMA may be an effective intubation guide, it doesn't blunt hemodynamic changes effectively than standard laryngoscopic intubation.