These new national guidelines from the Difficult Airway Society and Obstetric Anaesthetists' Association aim to provide a consistent framework for providing safe obstetric general anaesthesia and the management of unanticipated difficult tracheal intubation, failed tracheal intubation and the ‘can't intubate, can't oxygenate’ (CICO) situation. Discussion of management after failed intubation covers the different actions to be taken should the anaesthetist decide to wake the patient or proceed with general anaesthesia. The difficulty in making this decision is acknowledged by including criteria that aim to aid selection of the most appropriate option in the light of the differing circumstances of each particular case.