Background: Unexpectedly challenging laryngoscopy may still be a significant issue despite the adoption of several clinical index tests for airway evaluation. The aim of the study is to evaluate the efficacy of ultrasonography for predicting difficult intubation in patients who need emergency surgical treatment and are obese.. Method: this a prospective single center, double blind Cohort study, included as many eligible patients over period of 6 months whom were obese patients without clear anatomical abnormalities undergoing urgent surgeries and receiving general anesthesia, 349 patients included and divided to Control group (c) who were non obese patients, Obese group (O) with BMI >30 kg/m². Results: a significant difference recorded between the two groups as regard the weight which was higher in obese patients (92.1±6.2), and consequently the BMI was (34.8±4.9). Also, a significant difference in the clinical assessment between two groups, incidence of difficult laryngoscopy DL (20.3%) of obese patients, Conclusion: In obese individuals, ultrasonography might foretell a more challenging laryngoscopy.