Each year in the USA there are approximately 10000 new cases of spinal injury and the cervical spine is most commonly affected. This chapter presents a case study of a 27-year-old male who was immobilized on a spinal board, with rigid cervical collar. The anterior portion of the cervical collar was removed, manual in-line stabilization (MILS) maintained and cricoid pressure was applied. The immobilization of the spine in trauma patients until injuries have either been excluded or definitively treated remains a cornerstone of modern trauma care. The anesthesia provider must maintain the mechanical integrity of the spinal cord by limiting neck movement, as well as ensure adequate spinal cord perfusion by avoiding hypotension and subsequent tissue hypoxia. The degree of movement and angulation in spinal segments with any of these intubation techniques is of uncertain clinical significance.