In this video, we review the relevant anatomy, tools and positioning, technique, and tips for cricothyroidotomy, using media from our institution's cadaveric fresh tissue dissection lab. Cricothyroidotomy is the surgical airway of choice in the emergent setting. It is indicated when attempts at orotracheal intubation or LMA have failed in adult patients. Identification of landmarks is crucial to the procedure. The four finger technique allows for identification of the cricothyroid membrane. The surgeon's four fingers are extended side by side with the small finger in the sternal notch. The surgeon's index finger is then pointing at the ideal surgical site. The larynx is stabilized with the nondominant hand and a vertical skin incision is made, 3-4 cm in length, overlying the cricothyroid membrane. A vertical incision should be used so as not to damage the anterior jugular veins and to stay in the avascular plane of the median raphe. A scalpel is used to divide the cricothyroid membrane in a transverse orientation. Pressure should always be held on the thyroid cartilage to maintain immobilization of the airway. A tracheal hook is used to retract the thyroid cartilage. A bougie can then be inserted into the airway with either an endotracheal tube or tracheostomy tube. Alternatively, the tracheostomy tube can be inserted with its obturator, the obturator removed, and the inner cannula inserted. Once placement is confirmed with carbon dioxide detection and auscultation of breath sounds, ventilation can proceed.