The two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. This new study compares their use for elderly patients undergoing low risk surgery with a composite of postoperative pulmonary complications as the primary outcome.  It is a fascinating trial for many reasons and we expect there will be much discussion amongst anaesthetists. Join Prof Mike Irwin and the authors to find out why they did it and a summary of the key clinical messages.