This study was done on 40 patients that were randomly assigned to two equal groups of 20 patients each according to the used technique of endotracheal intubation as follows: (Group1): Intubating Laryngeal Mask technique and (Group2): Direct laryngoscopy technique. All patients were assessed by Al Ganzouri scoring system. The patients attached to monitors and after induction the device inserted (ILMA, Macintosh blade) according to their group. Data collected about: (Time needed for device insertion, Change in angles C1/C2 and C2/C3 before, during and after intubation, Vital signs as oxygen saturation, heart rate and blood pressure).Post intubation the patients assessed of presence of bloody mucosa.