Current pulse oximetry sensors are not very well suited to use in anaesthetised patients as it has been shown that during episodes of reduced peripheral circulation they do not function correctly or fail all together [1], [2]. To address this problem a new design for a photoplethysmography (PPG) endotracheal (ET) sensor to monitor pulse rate and oxygen saturation (SpO2) internally is presented. Flexible printed circuit board (PCB) technology and miniature optoelectronic components have been implemented and integrated with a custom instrumentation system [3]. The sensor adheres and conforms to the curvature of standard french-gauge 7 and 8 ET tubes at the point just above the inflatable cuff within the laryngeal positioning markings. A 3D-modelled, optically clear, soft silicon encapsulation electronically and thermally isolates the electronic components whilst providing a smooth surface to aid the insertion on the ET tube during standard intubation procedures. A pilot study with 5 patients (3 Female, 2 Male), undergoing abdominal and limb laproscopic procedures has demonstrated the operation of the sensing ET tube, showing good quality red and infra-red PPG signals. Preliminary signal analysis reveals heart rate can be measured via PPG successfully, with saturation (SpO2) readings in close agreement with the commercial monitors of 97.9 % (STD 0.2 %) and 98.6 % (STD 0.8 %) respectively.