Background: To secure any ordinary, potentially challenging, or challenging airway, an anesthesiologist must acquire and become proficient in the fundamental technique of endotracheal intubation. The present study was conducted to compare the efficacy of nebulisation with 4% lignocaine versus spray as you go technique for awake fiberoptic intubation. Materials & Methods: 50 patients with difficult airway of both genders were selected. Patients in group I were nebulised with 4mL of 4% lignocaine while group II patients received four aliquots of 1mL 4% lignocaine through the working channel of the fiberoptic bronchoscope. The patients were compared for haemodynamic parameters, intubating conditions, intubation attempts, time taken for intubation and patient satisfaction score. Results: The mean age in group I was 37.2 years and in group II was 36.5 years. The mean weight was 62.3 kgs in group I and in group II was 64.2 kgs. The mean height was 170.4 cmsin group I and in group II was 172.3 cms. The difference was non- significant (P> 0.05). The mean MAP was 94.7 mm Hg in group I and 92.4 mm Hg in group II. The mean heart rate was 82.4 beats per minute in group I and in group II was 86.2 beats per minute. Time taken for intubation was 4.7 minutes in group I and 4.1 minutes in group II. The difference was non- significant (P>0.05). In group I and group II, four points score for intubating conditions was grade 1 seen in 20 and 12, grade 2 in 5 and 5, grade 3 in 0 and 7 and grade 4 in 0 and 1 patients respectively. Patient satisfaction score was excellent in 13 and 5, good in 12 and 9, reasonable in 0 and 10 and poor in 0 and 1 patients in group I and group II patients respectively. Conclusion: For awake fiberoptic intubation, the spray as you go approach is superior than nebulization with local anesthetic in terms of effectiveness and efficiency. It improves hemodynamic stability, intubating circumstances, patient comfort, and patient satisfaction.