Introduction:– Airway management of a challenging case of a pan facial trauma for a maxillo zygomatic mandibular osteotomy and plating Case Report:– We report a case of RTA of 23 years old male patient with pan facial trauma. Surgical repair of a complex maxillofacial trauma presents a challenge to the surgeon and anaesthesiologist. Where intubation via oral and nasal route cannot be performed, sub mental route of endotracheal intubation is very useful alterative. It obviates the need for tracheostomy and its related complications. We presented a case where we avoided tracheostomy in this patient and opted for the transmyelohyoid endotracheal intubation.