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Abstract Naso-Endotracheal Intubation (NEI) for anaesthesia in oral and maxillofacial surgeries are difficult in case of oral mass, micrognathia, restricted mouth opening, pathological anatomy of upper airway and restricted neck extension. This case report presents the clinical and anaesthetic management for a 46-year-old male patient recently operated for left buccal mucosa squamous cell carcinoma with restricted mouth opening of 1.5 cm, a big rent of 4× 5 cm on left cheek and restricted neck extension and flexion scheduled for forehead flap surgery. Patient was intubated with non-channeled Video Laryngoscope (VLS) assisted awake nasal intubation.