<p>Pediatric airway management can be much more difficult due to physiological and anatomical characteristics. Special attention should be paid to signs for a difficult airway when taking an anesthesiological anamnesis. This applies especially to children with syndromale diseases. During the induction of a general anesthesia, special attention should be paid to an optimal positioning of the child`s head (avoidance of a steep reclination or flexion of the head) and a correct “utilization” of the ventilation facemask. Securing the pediatric airway with a laryngeal mask can provide decisive advantages, especially for the less experienced as it is much simpler to manage. For endotracheal intubation apneic oxygenation should be used in every case, in order to prolong the apneic tolerance and to prevent oxygen desaturation. Video laryngoscopy should now preferentially be used in pediatric anesthesia, whereby both direct and indirect laryngoscopy-techniques can be performed. A change of the laryngoscope is no longer necessary and the first-pass success of the endotracheal tube is increased. The extubation can be performed with the child in both the supine or lateral position and also awake or asleep. The various possibilities have different advantages and disadvantages and should be used according to the preference of the anesthetist caring for the individual child. </p>