The recognition and treatment of the compromised airway needs to be quick and systematic. Airway obstruction, can rapidly progresses to anoxia irreversible cerebral damage and death, within four to five minutes. Management of the unstable airway has the highest treatment priority regardless of the presence of other medical conditions. We report the clinical course of minor anterior neck injury in two elderly patients taking oral anticoagulants. Both patients developed sudden airway obstruction, due to circumferential neck haematoma; six to eight hours post injury. The rapid neck swelling caused upper airway compression and rapid desaturation. Both patients required urgent orotracheal intubation in the emergency room. Patients with a history of blunt neck trauma may initially appear stable, then quickly decompensate and require an emergency airway.