Twenty-two patients were referred over a 3-year period for endoscopic evaluation of the upper airways. The diagnosis of acute upper airway obstruction was suspected from clinical means, and 8 of the 22 did prove to have critical encroachment of the upper airways requiring tube passage for stabilization. This technique utilizing the fiberoptic bronchoscope for diagnosis and tube placement represents the approach of choice in the adult population with acute upper airway obstruction.