Background: For every anesthesiologist, securing the airway is a crucial procedure. A problematic airway is a clinical scenario where a normally educated anesthesiologist has trouble with tracheal intubation, face mask ventilation of the upper airway, or both. The present study was ultrasound guided airway assessment to predict difficult intubation. Materials & Methods: 75 patients who underwent general anaesthesia for elective non-obstetric surgeries were divided in 3 groups according to depth of mucosal layer of tongue from the skin. Group I included those with skin mucosal distance of 3.5-5.4 cm, group II with 5.5- 5.8 cm and group III with distance more than 5.8 cm. Airway evaluation by modified Mallampati score and measurement of depth of tongue by USG were done to correlate with the ease of intubation with direct laryngoscopy as indicated by modified Cormack Lehane grading. Results: According to Cormack &Lehane Grade, 100% in group I, 84% in group II and 41% in group III had no difficulty. The difference was significant (P< 0.05). In group I, 74% belonged to MP1, 26% to MP2. In group II, 48% belonged to MP1, 49% to MP2 and 3% to MP3 and in group III, 23% belonged to MP1, 77% to MP2. The difference was significant (P< 0.05). USG had sensitivity of 76% and specificity of 87%. MP had sensitivity of 53% and specificity of 96%. The difference was significant (P< 0.05). Conclusion: The posterior third of the tongue's depth, as determined by ultrasound guidance, can be used to anticipate laryngoscopy difficulty. Airway ultrasound may be regarded as a crucial technique for pre-operative airway assessment due to its simplicity, lower inter-observer variation, and increased predictability. A supra-hyoid USG depth more than 5.8 cm indicates that laryngoscopy will be challenging.