In a patient with a known difficult airway, history and examination may be of limited use in formulating a management plan for subsequent tracheal intubation. Further detailed and descriptive review of the airway is necessary. Virtual imaging is a recent advance in radiology that offers noninvasive airway assessment. It creates a movie clip image of the upper airway akin to the view obtained through a fiberscope. We present a patient with Goldenhar syndrome in whom virtual imaging was used to identify the cause of a previous failed tracheal intubation.