Abstract: Objective: To observe the safety and effectiveness after the management of pre-anaesthetic,basal anaesthetic methods and intubation technique by fiberbronchoscope for difficult airway in children. Methods: Twenty-three children with difficult airway were sedated before operation and randomly separated into ketamine group (group A,10 cases) and sevoflurane group (group B,13 cases). Based anesthesia,nasal mucosa convergence,surface anesthesia and nasal fiberoptic guided intubation were applied to these children. The ratio of success and the complications during this period were recorded. Results: Twenty-three cases were successfully intubated. The average time of tracheal intubation was (11.8 ±2.4) min. The times of intubation (including changing hands) were 1-3. Fifteen cases could be extubated just when operation finished and eight cases could be extubated after operation in PACU. Three patients appeared apnea,upper airway obstruction and oxygen saturation decreased rapidly during intubation. Immediately stopping operation and intubated again when oxygen masks were given. Two cases appeared mild hoarseness after surgery and no after-effects by inhalation. There were SaO 2 lower,heart rate and mean artery pressure increased in two groups during intubation,especially in group A (P<0.05 to P<0.01). Conclusions: Well-prepared before intubation and sevoflurane based anesthesia treatment of nasal fiberoptic guided intubation in children with difficult airway,the success rate of intubation is high with little damage and few complications.