The LMA-CTrach combines the features of the Intubating Laryngeal Mask Airway with a fiberoptic system and a screen for visualization of the airway. Local pathology, such as lingual tonsillar hyperplasia, may obstruct the view of the airway leading to unanticipated difficult intubation. We present two cases of failed intubation with the LMA-CTrach in patients with lingual tonsillar hyperplasia. In both cases, the LMA-CTrach maintained adequate ventilation, giving time to prepare alternative strategies.