AbstractIntroduction: Difficult airway remains a frequent cause of anesthesia related morbidity and mortality due to difficulty with tracheal intubation. Around 30% of deaths attributable to anesthesia is mainly due to inability to manage difficult airways. For intubation in cases of difficult direct laryngoscopy many alternatives have been developed such as video laryngoscopes. Objectives: To Compare the ease of intubation by direct laryngoscopy and video laryngoscopy in patients with difficult airway. Outcome variables: Time taken for intubation, Number of Attempts of laryngoscopy for intubation and Cormack Lehane view. Methodology: 100 patients with difficult airway (Mallampatti class III, Upper lip bite test Score II and III, Neck mobility Score III) are divided into two groups of 50 each: Group A - Video Laryngoscopy group; Group B - Direct Laryngoscopy group. Time taken for intubation, number of attempts of laryngoscopy for intubation and glottic view were assessed in both Groups. Results: The time taken for tracheal intubation was shorter with Direct Laryngoscopy compared with Video Laryngoscopy. Number of attempts for tracheal intubation and laryngoscopic views were better with Video Laryngoscopy than with Direct Laryngoscopy. Conclusion: Video Laryngoscopy eases tracheal intubations in patients with difficult intubating conditions. The glottic view for guiding endotracheal tube is significantly improved, with a decreased number of optimizing manoeuvres resulting in a significantly higher success rate of tracheal intubations.