Airway management is a basic skill for emergency doctors. Difficult airways are one of the most important challenges. In 2022, the American Association of anesthesiologists published the fourth edition of guideline on the management of difficult airways, which provided us with the latest evidence-based medicine about the definition, evaluation, preparation, management and extubation of difficult airways. To improve the status of airway management of emergency doctors in China, this paper interprets the key points and updates the contents of the guidelines from the perspective of emergency medicine.