Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 01 31 1444 1444 Aram Moradi Department of Anesthesia, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran. & Department of Anesthesia, School of Allied Medical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran. Raheleh Charmchi Department of Anesthesia, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran. Parisa MoradiMajd Department of Anesthesia, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran. Mohammadreza Jamshidi Department of Anesthesia, School of Allied Medical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran. 2025 10 09 2025 10 27 Unintentional extubation during prone-position surgery is a rare but critical airway emergency in anesthetic practice. We report a case of a 41-year-old obese female with predictors of a difficult airway undergoing elective lumbar laminectomy. Intraoperative dislodgement of the endotracheal tube, likely due to inadequate fixation, was promptly identified. Prone mask ventilation with an oropharyngeal airway maintained oxygenation until safe repositioning and reintubation were achieved. This case highlights the importance of rapid recognition, effective prone ventilation, and coordinated team response in managing airway emergencies in non-supine positions to optimize patient outcomes. https://aacc.tums.ac.ir/index.php/aacc/article/view/1444