We describe successful fiberoptic-guided tracheal intubation through the novel supraglottic "I-gel" airway in two uncooperative adult patients with genetic syndromes, learning disability, and predicted difficult airway, scheduled for complex dental treatment under general anesthesia. The I-gel maintained the airway immediately after induction, allowing oxygenation and ventilation. Location of the laryngeal inlet was successful on the first attempt with a fiberscope, and the tracheal tube was inserted into the trachea over the endoscope without complication in both patients. This report suggests another option for management of predicted difficult airways.