Background <p>Unexpected difficult intubation during general anesthesia can significantly increase patient morbidity and mortality. The McGRATH videolaryngoscope is recognized for its ability to enhance laryngeal visibility in patients with both difficult and normal airways. This study aims to compare the efficacy of McGrath videolaryngoscopes and Macintosh laryngoscope in adult patients under general anesthesia, utilizing data from prospective randomized trials.</p> Methods <p>A comprehensive literature search was performed across databases including PubMed, Web of Science, and Embase. Data on the success rate of the first intubation attempt, intubation time, and glottic visualization during tracheal intubation were extracted from the identified studies. The data were analyzed using Stata 15 software. The risk of bias was assessed using the five domains of the Cochrane Collaborations tool.</p> Results <p>Nineteen articles met our inclusion criteria. The McGrath laryngoscope demonstrated superior glottic visualization compared to the Macintosh laryngoscope (RR, 1.47; 95% CI, 1.14 to 1.89). However, there were no significant differences between the McGrath and Macintosh laryngoscopes in terms of intubation time (SMD, 0.35; 95% CI, -0.14 to 0.85) and the success rate of the first intubation attempt (RR, 1.01; 95% CI, 0.96 to 1.07). Additionally, there were no statistically significant differences in the incidence of sore throat between the two laryngoscopes (RR, 1.00; 95% CI, 0.71 to 1.42).</p> Conclusions <p>Our study indicates that the McGrath videolaryngoscope provides superior glottic visualization compared to the Macintosh laryngoscope. Nevertheless, there are no statistically significant differences between the two laryngoscopes regarding first-attempt tracheal intubation success rates and intubation times.</p>