Abstract: Objective: This article reported the application of apneic oxygenation for difficult airway management in anesthetic induction of a mandibular fracture patient. Diagnosis and treatment: The patient faced challenges in preoperative airway management, including difficult tracheal intubation and the risk of aspiration and regurgitation. In this case, the article discussed the use of apneic oxygenation technique during the preoperative period. Results: Transnasal high flow oxygen inhalation through a nasal cannula was applied for preoxygenation, enabling a successful rapid sequence induction of general anesthesia with endotracheal intubation. Conclusions: This approach extended the patient’s safe apnea time, avoiding the need for awake tracheal intubation or a tracheostomy. It not only reduced the patient’s discomfort but also enhanced safety and comfort during the induction of general anesthesia.

Key words: apneic oxygenation, difficult airway, transnasal high flow oxygen inhalation, mandibular fracture, anesthetic induction