Background: Obstructive Sleep Apnea (OSA) is the most common sleep breathing disorder. In OSA, breathing is interrupted by a blockage of airflow. Objective: This study was aimed to assess the updated technique for endoscope-guided coblator tongue base reduction for the treatment of patients with OSA. Patients and Methods: This clinical trial study included a total of 12 patients with moderate and severe OSA, attending at the Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University Hospital. This study was conducted between April 2018 till August 2019. All the studied patients underwent coblation reduction technique for the treatment of retroglossal obstruction in combination with other palatal and/or nasal surgeries in a multilevel protocol. The tongue base was observed with a 30- degree angled, rigid endoscope (4 mm). Results: Male gender represents 75% of the studied patients. Age of the studied patient ranged from 38 to 54 years old with mean age 44.83 years (± 6.41), Oxygen desaturation index (preop.) was ranged from 30.3 to 56.9, while ODI (postop.) was ranged from 3.8 to 60.9. Conclusions: It could be concluded that tongue base reduction by coblation guided with endoscopy could be safe in management of obstructive sleep apnea without any dangerous complications.