Patients presenting for therapeutic bronchoscopy procedures commonly have multiple comorbidities and advanced lung pathology in addition to their compromised airway. Therapeutic bronchoscopic procedures can be divided into two categories: tumor-debulking procedures carried out with the intention to decrease tumor burden and size in the airway, thus minimizing the airway compromise; and procedures aimed at maintaining airway patency such as balloon dilatation and deployment of airway stents. Therapeutic bronchoscopic procedures are considered urgent and in some instances where the airway is compromised, the procedure is considered an emergency. Therapeutic bronchoscopic procedures performed through the flexible bronchoscope can be easily performed in the bronchoscopy suite outside the operating room under moderate sedation, monitored anesthesia care (MAC) or general anesthesia. Although endotracheal tubes are the definitive and most reliable airway devices in patients undergoing general anesthesia, they have their challenges when inserted in patients with central airway obstruction presenting for therapeutic bronchoscopic procedures.