Although maternal mortality resulting from anesthesia is declining, airway causes predominate. Although there are many physiologic and nonphysiologic factors that contribute to potential difficulties when intubating parturients, whether or not the maternal airway is more difficult anatomically continues to be debatable. What is more certain, however, is that the situation is more complex than other settings. Vigilance, avoidance, and preparation continue to be key to management. In cases of unexpected difficulty, which likely are unavoidable, several rescue devices may be helpful.