Water tubing accidents can result in significant morbidity and mortality, with injuries often following collisions with objects, boats, or other recreating individuals. A less frequent subgroup of these accidents is related to the towrope, which can cause severe injuries such as amputation or limb strangulation. Herein we report a case of a 14-year-old female who sustained significant airway injuries from a water tubing towrope strangulation that required a multidisciplinary approach and extensive follow-up. The resuscitation at a local hospital with a rapid sequence intubation was likely life-saving and allowed patient transfer to specialized care. This is the first published documentation of a non-lethal strangulation by water tubing towrope that underscores the importance of pre-hospital decision-making and local stabilization.