An examination of the upper airway with a fibre optic flexible endoscopy is a valuable investigation in difficult intubation is anticipated by anesthetist. This can be done in OT before the induction. Here the Anesthetist is assessing the upper airway in a patient who had Trachestomy 18 months ago.Flexible fibre optic endoscope is used here. This is done in Jubilee Hospital Trivandrum, South India.