Background and Aims: Endotracheal intubation is an essential part of general anaesthesia. Many tests are used to predict difficult intubation, but sensitivity and positive predictive value of these tests is low. This study aimed to study the predictive value of acromioaxiollosuprasternal notch index (AASI) for difficult visualization of larynx (DVL). Methods: After Hospital ethical committee approval, 200 adult patients undergoing General Anaesthesia were enrolled into the study. AASI and thyromental distance were measured preoperatively. Visualisation of larynx was graded by Cormack lehane grading with grade III and IV considered as DVL. Direct laryngoscopy was carried out by experienced anaesthetists blinded to the above mentioned airway predictors. Results: DVL was  observed in 8% patients. We found that sensitivity, specificity and AUC of AASI for difficult intubation to be 62.5(35.4– 85.8), 95.11(90.92–97.74), 0.79(0.72– 0.84) respectively. AUC of AASI was found to be better than Thyromental distance. Conclusion: AASI > 0.5  is a good predictor of difficult visualisation of larynx at direct laryngoscopy when compared to thyromental distance.