An emergency surgical airway may be a life-saving procedure in situations where other airway management techniques have failed or are contraindicated. Whilst the incidence of the can’t intubate, can’t oxygenate (CICO) scenario is low, with estimates ranging from 1/50,000 intubations in the operating theatre to 1/100 intubations in the Emergency Department, being able to gain access to the airway via the anterior neck is an essential rescue option. The technique described on this course is an open surgical technique as higher success rates are achieved when compared to needle cricothyroidotomy techniques.