Tracheal intubation is performed as part of daily routine in the operating room, rarely with complications. However, management of airway for cases such as a penetrating neck trauma case might constitute exceptions, in which cases the stabilization of the neck to prevent any further neural damage is a significant source of concern for the anesthesiologist. Generally, intubation techniques for penetrating neck trauma were planned according to the initial position of patients. To our knowledge, this is the first case report of alterated the position of the patient during the anesthesia induction for direct laryngoscopy. We report a case of successful airway management of a patient with penetrating neck trauma, by endotracheal intubation with direct laryngoscopy (DL) technique.