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Background and objectives: Lipoma represents very common soft tissue tumour, which may appear anywhere in the body. Appearance of a giant lipoma at the nape of neck, can severely compromise neck extension especially in elderly patients where age related degenerative changes in airways present significant challenges to anesthesiologists in airway management whenever needed. This paper evaluates the role of Ambu® aScope™ 3 in such a patient. Case report: An expected case of difficult airway where an old man presents with a huge lipoma of 15.5 × 12.4 cm at the nape of neck where we achieved awake intubation using a non-fiberoptic flexible bronchoscope Ambu® aScope™ 3. In the absence of fiberoptic bronchoscope, this device helped us secure airway in this very challenging case. Conclusion: Ambu® aScope™ 3 can be used for elective awake intubations in patients with difficult airways.