Several earlier reports have described life – 
threatening airway obstruction during arthroscopic 
shoulder surgery performed under regional anesthesia, 
caused by the leakage of irrigation fluid out of the 
shoulder joint space into the surrounding soft tissues, 
neck, pharynx and upper airway. Here, we present the 
case of a 32- year- old male in whom the use of general 
anesthesia with endotracheal intubation for shoulder 
arthroscopy surgery may have protected the patient from 
a possible fatal complication; he developed fluid 
accumulation in to the extra-articular soft tissues with 
subsequent tracheal compression - a very rare 
complication associated with this surgical technique. We 
recommend general anesthesia with endotracheal 
intubation for procedure performed by surgeons without 
an adequate experience, and periodic neck examination of 
any patient undergoing arthroscopic shoulder surgery, 
especially under general anesthesia as anesthetized 
patients cannot complain of breathing difficulty.