 There is an increased risk of difficult laryngoscopy among obese patients compared with subjects with normal body mass index.2,3 Optimal laryngeal view during laryngoscopy can be facilitated with proper head and neck positioning, including slight elevation of the head, neck flexion relative to the chest, and extreme atlanto-occipital extension.4 The ramped position, where the patients ear is horizontally aligned with their sternal notch, has been found to be superior to the standard sniffing position, 7-cm occiput elevation, during direct laryngoscopy in morbidly obese patients.4 