Abstract: Objective To observe the intubation difficulty of visual rigid laryngoscope via midline approach in completing endotracheal intubation in obese patients. Methods One hundred and twenty patients scheduled for surgery under general anesthesia with endotracheal intubation in Chinese PLA General Hospital from March to September in 2017 were enrolled. Before the surgery, patients' height, weight, body mass index, neck circumference, thyromental distance, width of mouth opening, modified Mallampati test score (MMT), upper lip bite test, as well as incisors protrusion, snoring history and small mandibular were recorded. Both obese group (n=60, BMI≥30 kg/m²) and control group (n=60, BMI< 30 kg/m²) had completed endotracheal intubation with visual rigid laryngoscope via midline approach. And the intubation times, the time required for intubation and whether assistance was needed were recorded. Results One case failed in the first attempt at intubation in obese group and one case in control group.While after adjusting the distal tip of the tube, the intubation was successfully completed at the second time. The first pass success(FPS) rates were both 98% in two groups. There were significant differences in snoring history, modified Mallampati test score and neck circumference between two groups (all P< 0.05), while no statistically significant difference was found in the frequency of assistance (33% vs 30%, P=0.690) and the time required for intubation (28±14) s vs (26±13) s, P=0.062. Conclusion Obesity does not increase the intubation difficulty when using visual rigid laryngoscope via midline approach.