AbstractIntroduction: The Laryngeal Mask Airway (LMA) was designed to facilitate separation of the gastrointestinal and respiratory tracts, improve the airway seal, enable controlled ventilation and diagnose mask misplacement. A Drain Tube (DT) enables diagnosis of mask misplacement and also aims to attenuate risks of gastric inflation, regurgitation and aspiration of gastric contents. Aims and Objectives: Our objective is to compare digital insertion and bougie guided insertion of the ProSeal LMA with respect to the oropharyngeal leak pressure, number of attempts to successful placement, effective airway time, airway trauma insertion, postoperative airway morbidity and hemodynamic response to insertion. Materials and Methods: In our study, compared ProSeal LMA insertions using the digital and bougie guided techniques in 40 adult ASA I & II patients randomized into Two Groups of 20 patients. Results: The study finds that effective airway time (37.3 ± 3.7 seconds vs 20.8 ± 3.0 seconds) and oropharyngeal leak pressure (31.8 ± 1.7 cm H2O vs 24.2 ± 3.2 cm H2O) are higher in the bougie guided group as compared to the digitally inserted group and that this association is statistically significant. The two techniques are comparable with respect to other parameters. Conclusion: The bougie guided technique of insertion of ProSeal LMA is an acceptable alternative to the digital technique. It has advantages of having a higher leak pressure and lesser chance if malposition. The disadvantages include a higher effective airway time and the potential for stimulation and trauma.