Cricothyroidotomy is the emergency surgical airway of choice. It is indicated for patients who require an emergency airway but cannot be intubated oro- or nasotracheally and cannot be oxygenated and ventilated using airway rescue techniques. These patients commonly include those with severe laryngeal or maxillofacial trauma, laryngeal edema, or a large neck hematoma. Cricothyroidotomy can be performed using an open or percutaneous technique. Rapid identification of key surface landmarks, including the thyroid cartilage, cricoid cartilage, and cricothyroid membrane, is critical. In patients with obscure anatomy, the four finger technique provides a quick and useful method to approximate the location of the cricothyroid membrane.