Respiratory tract obstruction due to a blood clot may result in life threatening ventilatory impairment. Ball valve blood clot obstructions of the airways are rare. A ball valve blood clot acts as a one-way valve, allowing (near) normal air entry into the airways, but (completely) blocking expiration. In a near fatal case of obstruction of the airways by a ball valve blood clot, we performed 'whole tube suction' to resolve the airway problem.