Introduction: Awake fiberoptic intubation has for many years been the gold-standard in patients with difficult airway. Videolaryngoscopy has already shown some advantages in patients with a difficult airway and compared to fiberoptic intubation it uses a technically simpler equipment and it is easier and quicker to learn. The aim of this article is to discuss awake videolaryngoscopy as an alternative to awake fibreoptic intubation and some practical aspects regarding regional anesthesia. Material and Methods: We report the successful tracheal intubation of 10 awake patients using the videolaryngoscope C-MAC ® D-blade TM . Administration of atropine and sedation with alfentanil and midazolam was performed. Anesthesia was achieved with spray applied on the surface of the tongue and oropharynges, a bilateral submucous block of the glossopharyngeal nerve and a transtracheal injection. Results and Conclusions: The technique was successful on the first attempt in the 10 cases. Regional anaesthesia and sedation were sufficient, once ventilatory and hemodynamic stability were observed, except in 1 case where tachycardia, hypertension and mild agitation were noted, without however compromising the procedure and with no need for further intervention. Our cases series suggest the hypothesis that videolaryngoscopy can be an alternative to fiberoptic intubation in awake patients. We also suggest it is easier to learn and can be performed with a similar success, security and comfort of patients.