We aimed to evaluate the efficacy and safety of flexible bronchoscopy-guided tracheal intubation during difficult airways. We retrospectively evaluated the hospital records of intubated patients with the assistance of a flexible bronchoscope during 5 years-period, (between January 2015 to 2020). All patients were intubated under general anesthesia. A total of 67 patients were enrolled in the study. The majority of the patients were male (n=42, 62.7%). The mean age was 55.5±15.3 years. Mallampati classification was revealed frequently in class IV in 76.1% of cases. Only one patient with class II is evaluated as having a difficult airway because of obesity. The most frequent 3 indications for endotracheal tube (ETT) insertion (intubation) with the help of a bronchoscope were limitation of the mouth opening (40.3%), obesity (20.9%), and cervical-vertebrate fracture (11.9%). The intubation route was preferred as the oral way in 53 patients and the nasal way in 14 patients. The mean duration for ETT intubation via bronchoscopy guidance was 3.38 minutes. There was no severe complication other than transient oxygen desaturation (SaO2) below 90% (n=8, 11.9%) and epistaxis (n=2, 3%) in the complication records of all patients. Intubation with the help of a flexible bronchoscope is an effective, practical, and safe method in patients with a difficult airway.