Thyroid diseases have an anaesthetic implication that includes difficult airway management, uncontrolled hyperthyroidism, hypothyroidism and post-thyroidectomy complications. Securing airway via Intubation and Extubation both require skilful management and timely decision to reduce morbidity and mortality in the case of thyroid abscesses and acute suppurative thyroiditis that leads to tracheal compression and deviation. We commenced the anaesthetic management in a series of patients with thyroid abscess leading to tracheal compression and deviation. We managed the cases with either conventional laryngoscope with bougie as facilitator, awake fiberoptic intubation and guided extubation.