This case report describes the successful use of the Airtraq optical laryngoscope to perform nasotracheal intubation on a patient with a fracture of the zygomatic arch and cervical spine injury. The patient had a restricted mouth opening of 16mm, making direct laryngoscopy difficult. The Airtraq laryngoscope provided an unobstructed view of the vocal cords and allowed nasotracheal intubation to be completed in 12 seconds without complications. The report concludes that the Airtraq laryngoscope can help facilitate nasotracheal intubation in difficult airway cases, such as when cervical spine immobilization is required.