The study investigated whether preshaping double-lumen endotracheal tubes (DLTs) to the shape of a video laryngoscope blade improves intubation success in patients undergoing thoracoscopic surgery. In a randomized controlled trial, 90 patients were enrolled and divided into two groups - a group with preformed DLT according to blade curvature (group P) and a group with traditional shaping (group T). Group P achieved a significantly higher success rate of intubation on the first attempt (91.1% vs. 72.7%), shorter tube passage time through the vocal cords (23.1 s vs. 29.5 s), and reduced total intubation time (58.3 s vs. 82.6 s). During intubation, group P showed lower values of blood pressure and heart rate. Postoperative complications, such as pharyngeal pain and lip injuries, were significantly less frequent in the P group (13.3% and 6.7% versus 31.8% and 18.2%). The conclusion of the study confirms that DLT preshaping improves intubation success and reduces the risk of intubation-related injuries.