STUDY OBJECTIVE:To determine whether tracheoscopy is an accurate and quick method for verifying correct placement of the tracheal tube after intubation. DESIGN:Prospective, randomized study. SETTING:Operating rooms of a teaching hospital. PATIENTS:26 patients scheduled for surgery and general anesthesia. INTERVENTIONS:8.0-mm tracheal tubes were inserted into both the trachea and the esophagus. Tracheoscopy was performed consecutively through both tracheal tubes by a variety of clinicians. MEASUREMENTS:The times taken to correctly identify the trachea and the esophagus were recorded. MAIN RESULTS:Correct identification of either the esophagus or the trachea occurred with a 100% sensitivity and a 96% specificity. The mean time to recognize either the trachea or the esophagus was 22.0 seconds. CONCLUSIONS:Tracheoscopy is a reliable method for quickly verifying proper endotracheal placement of a tracheal tube.