Patients with oral cavity cancer have specific features for airway management during anesthesia. A 60-year-old woman who had undergone eight different surgeries including uvulectomy, tonsillectomy, maxillectomy, and reconstruction with calvarial bone graft due to a diagnosis of squamous cell palate cancer 24 years ago was scheduled for laparoscopic cholecystectomy. Standard oropharingeal evaluation could not be preformed and neck extension was found to be limited due to previous operations. Vocal cords could not be seen during laryngoscopy because of; limited mouth opening due to fibrosis and impaired anatomical structure. Endotracheal intubation was performed using difficult intubation stylet (gum elastic bougie).