Since its introduction into clinical practice in 1988, the laryngeal mask airway (LMA) has been used as an alternative device to achieve and maintain control of the airway during anesthetics. The LMA has been used primarily in patients undergoing peripheral procedures in the supine position. The authors describe its use in an open intracranial neurosurgical procedure for a patient with a space occupying lesion. To our knowledge, this is the first such description in the literature.