The article addresses the topic of airway changes caused by radiation therapy that lead to the need for awake intubation. Awake intubation is a medical procedure in which a patient remains conscious during the insertion of an endotracheal tube into the airways. Radiation therapy can cause various changes in airway tissues that complicate their accessibility and manipulation. This article is published in a professional monthly journal for anesthesiologists in the United States. The material is part of the Anesthesiology News publication, which is the most widely read anesthesiology publication in the USA. The article highlights the importance of understanding radiation-induced changes when planning anesthetic care.