This chapter explores the well-established skill of upper airway endoscopy as a tool for assessing the upper airway and planning the best airway management approach for anaesthesia. It also describes the emerging modality of virtual airway endoscopy, which can examine both upper and lower airway, and its potential roles. Both techniques focus on examination of the air column within the airway (Greenland’s ‘middle column’) but can reach beyond the sight of the naked eye. Both techniques have potential to aid understanding of the patient’s airway anatomy and pathology and can enable improved airway planning.