The purpose of this narrative review is to investigate the existing evidence supporting the use of the snorkel breathing technique in anesthesia practice. In addition, this review aims to identify certain patient scenarios where the snorkel breathing approach can be appropriate. A total of nine articles relevant to anesthesia and airway management were retrieved using the search strategy. A review of the final papers found that the snorkel breathing technique offers a few advantages over using a regular face mask in the operating room. The snorkel or mouthpiece breathing approach can be as effective as the traditional face mask for successful preoxygenation, as defined by an end-tidal oxygen concentration greater than 0.9. The snorkel breathing approach can be a viable option in patient populations where face mask application is challenging. It also has greater acceptance than the face mask among patients and healthy volunteers. Another advantage of the snorkel breathing technique is that it can be utilized to provide apneic oxygenation during rapid sequence induction using short-acting neuromuscular blocking drugs, reducing the use of plastic (face mask). For older children and claustrophobic adults who are apprehensive about masks, snorkel gas induction can make anesthesia induction smoother and more pleasant. The snorkel breathing technique has potential application in certain anesthetic scenarios, and this narrative review also incorporates the author's clinical experience with it. To validate the effect of this novel technique (snorkel preoxygenation and snorkel gas induction) on patient-centered outcomes, more randomized controlled trials are required. For older children and claustrophobic adults who are apprehensive about masks, snorkel gas induction can make anesthesia induction smoother and more pleasant. The snorkel breathing technique has potential application in certain anesthetic scenarios, and this narrative review also incorporates the author’s clinical experience with it. To validate the effect of this novel technique (snorkel preoxygenation and snorkel gas induction) on patient-centered outcomes, more randomized controlled trials are required. Apneic oxygenation mouthpiece pediatric gas induction plastic waste sevoflurane snorkel breathing snorkel gas induction Even though face masks are the standard of care during airway management, the snorkel breathing technique can be utilized in certain clinical scenarios. There are ongoing efforts to pave the road for ecologically friendly anesthetic techniques.[ 4 ] As a result, an alternate airway management (snorkel preoxygenation and apneic oxygenation) approach that promotes greener anesthesia must be supported. This narrative review investigates the feasibility, applicability, and benefits of the snorkel breathing technique in the intraoperative context as part of preoxygenation and anesthetic gas induction. Figure 1 PRISMA flow chart showing the search strategy Table 1 Details of articles on the snorkel breathing technique in anesthesia Author Year Application Conclusion Everatt et al .[ 5 ] 1998 Preoxygenation with a face mask or mouthpiece with or without nose clip Part 1: 52 adult patients were surveyed about their preferences. Part 2: A comparison of the mean rate of EtO 2 increase with different procedures in 18 adult anesthetic volunteers was analyzed. Patients preferred the mouthpiece over the facemask. However, a mouthpiece with a nose clip improved patient acceptance and provided efficient pre-oxygenation. Pandit et al .[ 8 ] 2003 Comparison of vital capacity breathing method and three minutes tidal volume breathing while using mouthpiece with a nose clip Three minutes of tidal volume breathing is as effective as eight vital capacity breaths using a mouthpiece with a nose clip. Nimmagadda et al .[ 9 ] 2016 Comparison of snorkel preoxygenation with NuMask® versus a traditional face mask in 30 healthy volunteers. Mouth breathing with NuMask® is as effective as the classic face mask in achieving maximal pre-oxygenation. Tosh et al .[ 10 ] 2016 Preoxygenation using a mouthpiece For claustrophobic patients, pre-oxygenation with a mouthpiece can be an alternative technique. (author’s own creation) Figure 7 Snorkel gas induction flowchart (author’s own creation) Reduction of plastic burden Plastic waste is a big concern in anesthesiology practice and the tendency is toward single-use disposable plastic devices.[ 44 45 ] A few common steps toward greener anesthesia include low-flow anesthesia, avoidance of nitrous oxide, use of total intravenous anesthesia, and regional anesthesia techniques.[ 46 47 ] The preoxygenation and apneic oxygenation using the snorkel technique are conducted with the breathing tube, eliminating the need for a disposable face mask. Hypothesis for Future Research Because there is minimal leak and the snorkel breathing technique bypasses the nasopharynx (avoids the nasal and nasopharyngeal deposition of volatile agents), it can be hypothesized that the snorkel breathing approach induces quick hypnosis. However, randomized controlled experiments comparing the speed of onset of the snorkel and facemask techniques are required to obtain a conclusive result. Positive airway pressure is commonly used during preoxygenation. The administered positive airway pressure may be dissipated due to a poor mask seal. The snorkel breathing technique is an easy-to-perform technique that could be a useful addition to the airway arsenal. Applying snorkel breathing in the operating room should not be a difficult task because most people, including children, have experienced it as part of aquatic sports. Also, many women have been exposed to mouthpiece breathing during Entonox administration in labour. Compared to traditional face masks, the snorkel breathing technique offers numerous benefits. Snorkel preoxygenation and apneic oxygenation can reduce the plastic waste burden, paving the way for greener anesthesia.