We report a case of general anesthesia for male infant with a chromosome 14q terminal deletion syn- drome. In this syndrome, congenital abnormalities such as brain malformations, gastrointestinal and male geni- tourinary abnormalities have been reported as well as some cranio-facial features (micrognathia, dysplastic low-set ears, telecanthus and small mouth, etc.). Gen- eral anesthesia had been performed on him for several times, but his face, presented some typical signs with his growth. At three years of age, we presumed the difficulty in keeping his airway after induction and chose awake intubation with a video laryngoscope and we could perform tracheal intubation. We suggest that the major anesthetic considerations for patients with a chromosome 14q terminal deletion syndrome would be the difficult airway during induc- tion and the respiratory difficulties during perioperative period.