The spectrum of anesthesia for major spinal surgery in adult life is considerable, such as spinal stabilization following trauma or neoplastic disease, or for correction of scoliosis, or with risk in extending the neck with some auto immune diseases such as rheumatoid arthritis and it presents a number of challenges, especially airway management which may be difficult. Flexible fiberoptic intubation is a tremendously useful technique, which every anesthetist should attempt to master. The advantage of vision needs no explanation. It is the most effective solution in cases where difficult intubation is anticipated. In a survey of European emergency physicians' clinical practice more than half of the physicians considered that the fiberoptic bronchoscope provided the least cervical spine movement. However, most of the physicians who indicated the use of the fiberoptic bronchoscope as their preferred technique were not skilled in its use. The aim of the work is to focus on the importance of the fiberoptic bronchoscope in cervical diseases and trauma patients. And to discuss the techniques and adjuvant maneuvers to insure the safety of the patient during induction of anesthesia.