Background and Aims: Placing an oral endotracheal tube (ETT) accurately is always a challenge; however, achieving proper placement can reduce the risks associated with malposition.

This study aimed to assess the precision of inserting cuffed oral ETTs to the appropriate depth among Indian adults, focusing on how patient height influences this, according to standard guidelines.

Methods: 240 adults aged between 20 to 60 years of both genders who required endotracheal intubation  in operating rooms or were already intubated for various reasons and admitted in a tertiary care hospital while excluding individuals with haemodynamic instability or upper airway deformities. Following standard protocols, oral ETT intubation was performed securing ETT at  incisors, and ETT tip to Carina distance was measured. The study's power was maintained at 0.95. Microsoft Excel 2016 was used to analyze the collected data using both descriptive and inferential statistical tests.

Results: Only 60% of the ETTs were positioned correctly. Majority of the misplaced ETTs (40%) were positioned too deeply (36%). The equation, depth of ETT placement = [0.22×Height (cm) - 14.5], can aid in ideal placement of oral ETT with the tube tip safely above the carina in Indian adult patients.

Conclusions: Conventional ETT placement guidelines at incisors don’t meet Indian community. ETT placement correlates positively with patient height. Placing ETT at 20 cm and 22cm in females and males respectively will meet majority of people in Eastern India. We suggest to implement our equation over diverse demographics to aid in ETT placement to correct depth.