Introduction: The significance of difficult or failed tracheal intubation following induction isrnwell-recognized cause of morbidity and mortality in anesthetic practice. Nevertheless, the needrnto predict potentially difficult tracheal intubation has received a little attention. During routinernanesthesia the incidence of difficult tracheal intubation has been estimated at 1.5% - 8% ofrngeneral anesthetics. Difficulties in intubation have been associated with serious complications,rnsuch as brain damage or death, particularly when failed intubation has occurred. Occasionally inrna patient with a difficult airway, the anesthetist is faced with the situation where mask ventilationrnproves difficult or impossible. This is one of the most critical emergencies that may be faced inrnthe practice of anesthesia. If the anesthetist can predict which patients are likely to prove difficultrnto intubate, he/she may reduce the risks of anesthesia considerably. In Ethiopia there is no datarnon the magnitude of difficult laryngoscopic tracheal intubation and no standard guideline forrnpreoperative tests.The main concern of this study was to provide information on the magnitudernof difficult laryngoscopic intubation and to determine valuable preoperative tests to predictrndifficult laryngoscopy and intubation in patients with apparently normal airways which can helprnanesthetists to improve preoperative airway assessment and contribute to decrease anesthesiarnrelated morbidity and mortality.rnObjective:The main objective of this study was to assess the magnitude and predictive values ofrnpreoperative tests for difficult laryngoscopy and intubation, among surgical patients whornunderwent elective surgery under general anesthesia with endotracheal intubation in TikurrnAnbessa Hospital from February 1- March 30, 2016.rnStudy design: A facility based cross sectional study design was used.rnResult:In this study, we found the magnitude of difficult laryngoscopy and intubation as 13.6%rnand 5% respectively. 33.3% of Patients with difficult laryngoscopy were found to be difficult forrnintubation. Mallampatti test, interincisor distance and thyromental distance were identified to berngood preoperative tests to predict difficult laryngoscopic intubation when used in combination.rnRecommendation: We recommend anesthesia professionals to use combination ofrnMMC/TMD/IID for their routine preoperative airway assessmen