A simple preoperative grading system was developed to predict the difficulty of direct laryngoscopy based on the ability to visualize the faucial pillars, soft palate, and base of the uvula. This system was evaluated in 210 patients and found to be a reliable predictor of laryngoscopic difficulty (p < 0.001). The key clinical sign is the concealment of the faucial pillars and uvula by the base of the tongue when the tongue is maximally protruded. This sign is based on the hypothesis that a disproportionately large base of the tongue can obscure the view of the larynx, making direct laryngoscopy difficult. The study included patients with various anatomical features, including those with no teeth, overbite, or restricted neck mobility. The results showed that patients with all three structures visible had easy laryngoscopy, while those with only the soft palate visible had difficult intubation. The study supports the hypothesis that the visibility of the faucial pillars and uvula can predict the ease or difficulty of laryngoscopy. The method is simple, objective, and practical for clinical use. The study highlights the importance of anatomical factors in predicting difficult intubation and emphasizes the need for a reliable, objective method to assess airway anatomy. The results are statistically significant and support the use of this clinical sign in predicting difficult tracheal intubation.A simple preoperative grading system was developed to predict the difficulty of direct laryngoscopy based on the ability to visualize the faucial pillars, soft palate, and base of the uvula. This system was evaluated in 210 patients and found to be a reliable predictor of laryngoscopic difficulty (p < 0.001). The key clinical sign is the concealment of the faucial pillars and uvula by the base of the tongue when the tongue is maximally protruded. This sign is based on the hypothesis that a disproportionately large base of the tongue can obscure the view of the larynx, making direct laryngoscopy difficult. The study included patients with various anatomical features, including those with no teeth, overbite, or restricted neck mobility. The results showed that patients with all three structures visible had easy laryngoscopy, while those with only the soft palate visible had difficult intubation. The study supports the hypothesis that the visibility of the faucial pillars and uvula can predict the ease or difficulty of laryngoscopy. The method is simple, objective, and practical for clinical use. The study highlights the importance of anatomical factors in predicting difficult intubation and emphasizes the need for a reliable, objective method to assess airway anatomy. The results are statistically significant and support the use of this clinical sign in predicting difficult tracheal intubation.