Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 1 2024 03 05 523 525 Manoj Katewa Department of Anaesthesiology and Critical Care, Pt. B.D.Sharma PGIMS, Rohtak, India. Rashmi Rashmi Department of Anaesthesiology and Critical Care, Pt. B.D.Sharma PGIMS, Rohtak, India. Arvind Kumar Department of Radiodiagnosis, SMS Medical College, Jaipur, India. Manisha Kumari Department of Anaesthesiology and Critical Care, Pt. B.D.Sharma PGIMS, Rohtak, India. 2023 12 17 2024 01 14 Aspiration under general anaesthesia is a dreaded complication which can significantly affects the morbidity and mortility in the postoperative period. Factors such as delayed gastric emptying seen in obesity, pregnancy, paralytic ileus, altered consciousness as under general anaesthesia, head injury can predispose the patient to pulmonary aspiration. The two entities aspiration pneumonia and aspiration pneumonitis although difficult to differentiate in the early course of event but it is of crucial importance to know the pulmonary pathology for effective management of the patient. A morbidly obese patient was posted for fracture humerus surgery under GA who landed in cannot ventilate situation, had pulmonary aspiration which was managed efficiently in ICU. https://aacc.tums.ac.ir/index.php/aacc/article/view/912