Background: The usefulness of modified Cormack-Lehane scoring system (MCLS) used for laryngoscopy was introduced and used extensively Western population. This study was undertaken for evaluation of modified Cormack-Lehane scoring system in Indian population. Methods: 198 patients of more than 18 years of age requiring tracheal intubation were evaluated with preoperative airway predictors, the modified Mallampati test and thyromental distance (TMD). Result: The larynx was difficult to visualize (Cormack and Lehane grades IIIB and IV) in 18 / 198 (9.09 %) patients. No failed tracheal intubations occurred in any of the 18 cases. Conclusion: The Mallampati classification was associated with good predictive value for 3B and 4 of modified Cormack-Lehane scoring system. The MCLS better delineates the difficulty experienced during laryngoscopy than the original Cormack-Lehane grading.