Background: The main objective of this study is to evaluate the effectiveness of videolaryngoscopy, performed with the help of Trueview® device, for routine oro-tracheal intubations compared with visualization by direct laryngoscopy, performed with McIntosh laryngoscope. Material and method: The study enrolled 237 patients, aged between 4 weeks and 87 years, who underwent surgery under general anaesthesia with oro-tracheal intubation. Patients were randomized into two groups: videolaryngoscopy group VL (n=139) and direct laryngoscopy group DL (n= 98). Preoperative, for prediction of difficult airway, the following were evaluated: Mallampati score, thyro-mental distance, body mass index (BMI). During surgery, hemodynamic and respiratory parameters were monitored and also the peripheral oxygen saturation. The intubation time, the number of attemps and the success rate were recorded. Results: The success rate on first intubation attempt, was higher In the VL group, than the DL group, 96.4% and 86.7% respectively, without statistically significant differences between the two groups, p>0.05. Conclusion: The videolaryngoscope Truphatek TrueView® PCD is a useful device for the management of the patients with difficult intubation. The video-assisted techniques should be included in the protocol of difficult airway management of every anesthesia and intensive care compartment.