BACKGROUND: The spiral-wound tracheal tubes have the different flexibility, materials, and shape of bevel according to the manufacturers. Theses different tube characteristics may affect the ease of orotracheal intubation. So this study was designed to investigate the ease of fiberoptic orotracheal intubation with two different types of spiral-wound tracheal tube. METHODS: Seventy-one adult female patients who undergo fiberoptic intubation were randomly divided into two groups. Fiberoptic orotracheal intubation with silicone made spiral-wound tracheal tubes(M group) or silicone-rubber made spiral-wound tracheal tubes(R group) was performed. In the first attempt, the tracheal tube was advanced into the trachea over the pediatric fiberoptic laryngoscope which was orotracheally placed with the bevel of the tracheal tube oriented anteriorly at 12 o'clock direction. If the insertion was hindered the tracheal tube was withdrawn about 4~5cm backward and rotated 60o to the left(10 o'clock direction) and readvanced. If the second attempt was unsuccessful the tracheal tube was rotated 60o to the right(2 o'clock direction) and readvanced. If the third attempt was unsuccessful it was considered that the fiberoptic intubation was failed. RESULTS: Success rate of the first attempt was 23.7%(9/38) in group M and 72.7%(24/33)in group R(P<0.05). Failure rate was 23.7%(9/38) in group M and 3.0%(1/33) in group R(P<0.05). CONCLUSIONS: It should be considered that the ease of fiberoptic intubation is different according to different types of spiral-wound tracheal tube in the attempt of fiberoptic orotracheal intubation.