This case represents a classic example of right main bronchus intubation. The patient was intubated as part of induction of anesthesia for an elective surgical procedure. Unfortunately, high airway pressures were observed following intubation with the rapid development of bradycardia, hypotension and hypoxemia with subsequent cardiac arrest. Following a short period of cardiopulmonary resuscitation, return of spontaneous circulation occurred. This radiograph was taken immediately on admission to ICU. The etiology of this event may be secondary to the drugs used during induction or as a result of excessive stimulation of vagal tone with direct laryngoscopy, which has been reported in case studies1.