Supraglottic airways (SGAs) have been part of core anaesthetic practice for approximately 30 years, since the introduction of the classic laryngeal mask which is described in some detail. In many countries an SGA is now used for airway management for the majority of anaesthetics. Optimal use and insertion technique are described. The range of SGAs available and their roles have expanded dramatically in this time. Second generation SGAs are those designed to reduce the risk of aspiration and are emphasised in this chapter. With the wide range of SGAs available it can be problematic to decide which device to use and this is especially so as the boundaries of acceptable use are ever widened. This chapter describes those devices with the greatest versatility and utility – arguably also with the greatest safety profile too – and some newer devices. SGAs have a major role to play in advanced and difficult airway management. The use of an SGA as a rescue device and as a conduit for intubation during management of the difficult airway is described in detail.