In the Intensive Care Unit (ICU), endotracheal intubation is more difficult than that in the operating room and is also associated with a higher risk of complications. An appropriate decision making regarding the need for adefinitive airway, an airway algorithm, and the Rapid Sequence Intubation (RSI) improve the clinical outcome of the ICU patients. The purpose of this article is to review the airway management in the ICU, which includes airway evaluation, airway algorithm, RSI, and rescue techniques. (J Surg Crit Care 2012;2:29-38)