Awake endotracheal intubation is indicated when risk of pulmonary aspiration and difficult airway management is present. In this way, patient cooperation and topical anesthesia with experience of anesthesiologist in difficult airway management is necessary. In this case report, we present a 21-year-old man with (Body Mass Index) = 51 and 140 kg of weight candidates for lumbar discectomy in prone position. After conclusion about his condition with difficult anesthesia, awaked endotracheal intubation in supine position was done and self positioned to prone for operation.