Airway management for lung transplantation must take into consideration limited reserve, rapid desaturation, and altered respiratory physiology. A thorough airway assessment is essential for predicting anatomical challenges. Video laryngoscopy may enhance glottic visualization and reduce intubation time for double-lumen endotracheal tubes. For patients with tracheostomies or those bridged on extracorporeal membrane oxygenation (ECMO), individualized approaches to lung isolation are essential to ensure procedural success.