Reactive airway disease essentially denotes airway hyperresponsiveness or an exaggerated response to constrictor agonists. Acute increase in airway resistance may occur, either because of severe disease or because of previously unidentified reactive airways. Airway hyperresponsiveness, in suggested to be due to changes in either the quantity or properties of airway smooth muscle mass or changes in biochemical/biomechanical properties. Airway hyperactivity has often been explained parasympathetic activity. In managing a general anaesthetic for a patient with hyperactive airways, the primary goal is to prevent reflex airway constriction.