Awake fiberoptic intubation has been recommended for adult patients with a difficult airway in whom anaesthesia and/or relaxation could lead to the "cannnot ventilate, cannot intubate" situation. We describe the strategy and protocols of such management in cases with a predicted difficult airway. The described method is safe and effective, and can be recommended for cases where there is serious doubt about the possibility of maintaining an open airway during induction of anaesthesia, or in cases where intubation has failed during previous anaesthesia. Awake intubation is rarely associated with serious episodes of desaturation and it is usually well tolerated by motivated patients.