The prehospital emergency airway management is a key moderating factor for patient survival and mortality rates. There has been much debate around the optimum method of prehospital emergency airway management. This commentary critically appraises a recent systematic review which assesses the harms and benefits of three different airway management strategies for a range of emergency clinical scenarios. Commentary on: Carney N, Totten AM, Cheney T et al. Prehospital Airway Management: A Systematic Review. Prehosp Emerg Care. 2021;1–12. https://doi.org/10.1080/10903127.2021.1940400