Patients with tumors of the upper and lower respiratory tract may experience acutely worsening airway compromise due to edema, bleeding, infection, or loss of protective mechanisms. Presenting symptoms and signs include dyspnea, tachypnea, wheezing and stridor. Imaging involves plain radiographs, CT scan, and/or endoscopic visualization. Emergency measures include supplemental humidified oxygen, maintenance of airway through optimal patient positioning, and, possibly, administration of a helium-oxygen mixture. If intubation is required, an "awake look" with a fiber optic bronchoscope with a 5-0 or 6-0 endotracheal tube is preferred. An emergency surgical airway, such as cricothyroidotomy, transtracheal jet ventilation, or tracheotomy may be needed. Consult with an oncologist or surgeon for definitive management.