Ankylosing spondylitis (AS) is a chronic autoimmune, progressive collagen tissue disease characterized by the inflammation of the vertebra, sacroiliac joint, and the neighboring tissues. AS is a special disease for the anesthesiologist because of the possible problems/complications during the general or regional anesthesia. In this article; we aim to present our intubation method of a patient with a Fowler position after taking the operating table to a Trendelenburg position during the open rhinoplasty and total septal reconstruction. Open rhinoplasty and total septal reconstruction surgery under general anesthesia have been planned for a 61-year-old male patient diagnosed with AS 20 years ago. In the preop evaluation of the patient; there was a severe restriction of movement on the ASA 2, mallampati 2nd and 3rd cervical joints. It is impossible to make an extension or side rotation for the neck. The back movements of the patient were also heavily restricted. As a conclusion; with the patients who have AS, if we can place the patient to the table in a comfortable position like Fowler and take the table into the Trendelenburg position, we can extend our point of view and we can do the intubation easily with this easy method. With these kinds of patients; intubation in a Trendelenburg position can be a suitable approach after preparing all our necessary equipment for difficult intubation