Shared airway management is fundamental to a successful operation in otolaryngologic surgery; how to communicate with your anesthesiologist to avoid unnecessary airway complications is imperative. Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society (NAP4) demonstrated that 39% of major airway complications involved an acute or chronic disease of the head, neck, or trachea. Assessment, planning, and communication between teams were identified as contributing influences. Of those requiring a surgical airway, poor planning of an airway strategy and failure to change routine plans were recognized factors. As otolaryngologists we face a unique relationship with our anesthesia colleagues in the shared airway. While in most circumstances, this is a smooth transition, when airway complications arise, they are serious, rapid, and we are asked to perform the surgical airway. Unique patient populations in otolaryngology include acute and chronic head and neck cancer, professional voice, glottic and subglottic stenosis, and OSA. Unique planning for airway management includes awake fiberoptic intubation, LMA, ETT choice, jet ventilation (supraglottic and subglottic), awake IV sedation, and sleep endoscopy. Induction and emergence of anesthesia are the critical check points for successful ENT surgery; improved preparation and communication between colleagues can make the climbing and descending smooth and avoid turbulence.