SGA devices have been used successfully in patients of all ages in various clinical scenarios, including primary airway management under general anesthesia in the operating room, and resuscitation and emergent airway management in the emergency department (ED) and prehospital settings. SGA devices have been used as alternatives to face-mask ventilation and tracheal intubation by healthcare providers with proficient airway management skills, but also by those with less experience, to successfully oxygenate and ventilate the lungs. The clinical efficacy of SGA devices in children has been proven in a large number of clinical studies. Pediatric SGA devices have undergone an evolution in design since their introduction 30 years ago. These newer design features have improved the use of SGA devices to provide positive-pressure ventilation and facilitate fiberoptic-guided tracheal intubation. The evolution, versatility, and utility of the SGA device will be discussed in detail in this chapter.