BACKGROUND: Central venous cannulation is one of the important parts of anesthetic management. Because general anesthesia causes external-landmarks (e.g. sternocleidomastoid muscle, carotid artery pulse) indistinct, we developed a new external landmark for internal jugular vein cannulation that can be easily detected under general anesthesia. METHODS: We cannulated the right internal jugular vein of 110 patients under general anesthesia. We used the external jugular vein and cricoid cartilage as a landmark. RESULTS: Cannulation of the right internal jugular vein was successful in 108 out of 110 patients (98.2%). Patients required an average 1.48+/-0.63 attempts. There were 2 carotid punctures (1.8%), 3 discomforts (2.7%) and no brachial plexus irritation. CONCLUSIONS: This new landmark technique has a high success rate and few complications.