Patients with cervical cord trauma are at risk of having an unstable cervical spine and any movement of the neck can cause further damage. Therefore, the primary goal of airway management is to minimize neck movement while securing the airway. Cervical spine movement during intubation with direct laryngoscopy can predispose to new-onset neurological deficits in patients with cervical spine instability, awake fiberoptic guided intubation (FGI) is mostly preferred to eschew any further injury(1). Airway management and positioning of patients with unstable cervical spine are the two major challenges faced by anaesthesiologists. During the initial evaluation, the focus is on head positioning and stabilization. Any airway maneuver undertaken in such patients has the potential to cause damage and result in unforeseen neurological sequelae. Overall, managing a difficult airway in a patient with cervical spine injury requires careful planning, a team-based approach, and an awareness of the potential risks and complications associated with airway management in this patient population.