A prospective observational study design was used to evaluate the clinical effectiveness of the Frova single-use tracheal tube introducer. Data were collected from 203 patients. Consultants and trainee anaesthetists completed 61 (30%) and 142 (70%) forms respectively, when the Frova introducer was used. It was successfully placed in the trachea in 194/203 (96%) of patients with two attempts at placement by the first clinician. The first clinician failed to either pass the Frova introducer or railroad the tube in six (3%) and 10 (5%) of the 203 patients respectively. The success rate by the first clinician was significantly influenced by the laryngeal view obtained (p < 0.0001). There was only one failure to place the Frova introducer in the trachea by either the first or second clinician. Airway trauma was detected in 11/203 (5%) patients. In six of these 11 patients blood was detected on tracheal suction; 'distal hold up' was elicited in five of these six. The Frova introducer has a high success rate for tracheal placement but has noteworthy potential to produce airway trauma.