A common classification used by Anesthesiologists to grade the difficulty of laryngoscopy and intubation involves the identification of the size of the tongue in relation to the tonsillar pillars, the fauces, the soft palate, and the uvula.7 It is important to perform this evaluation by first instructing patients to open their mouths and protrude their tongues maximally in the sitting position. The patient should not say “ahhh,” as this distorts the anatomy and may falsely improve the airway classification. The Mallampati classification, named after its author, has four grades or classes.7 The anterior and posterior tonsillar pillars, the fauces, the soft palate, and the uvula can be fully visualized in class I (Figure 6-6A). The fauces, the soft palate, and the uvula can be visualized in class II (Figure 6-6B). The anterior and posterior tonsillar pillars are covered by the base of the tongue and not visible. Only the soft palate and the base of the uvula are visible in class III (Figure 6-6C). None of the structures are visible in class IV (Figure 6-6D). The predictive value of this classification is that during direct laryngoscopy, the entire glottis can be exposed in 100% of class I airways, 65% of class II airways, 30% of class III airways, and 0.1% of class IV airways.7