Ludwig’s angina remains a potentially life – threatening urgent condition affecting the posterior oropharynx, submaxiller and sublingual areas. Because of the airway obstruction in such cases death can be occurred. Tooth extraction , dental infection is the common cause of this cellulit. It causes edema, distortion, obstruction of the upper airway. Initially patients may be managed with observation and intravenous antibiotics(1). However advanced infections need to be treated surgically even in a few days. Awake fiberoptic intubation under topical anesthesia may be the ideal method, and in addition to this tecnique in advanced situations awake tracheostomy may be the succesfull option. Here we present the anesthetic management with urgent tracheotomy of a 32 year old woman who had had a tooth extraction a week ago with comorbidities, scheduled for emergency drainage due to the Ludwig’ angina.