Airway management of the multiple trauma patient presents a series of challenges. By definition, many trauma patients present difficult airways that require a different approach and formulation of a planned series of steps before airway management is initiated. Recognition of specific attributes of the difficult airway, knowledge of appropriate techniques, familiarity with various devices, and prompt recognition of failed airway circumstances are necessary for optimal patient outcome. This article reviews the attributes of the difficult airway, the definition of the failed airway, and devices and techniques to be used in the management of difficult and failed airways in the trauma patient.