Background: In cancer patients, who often come with anatomical and pathological problems, difficult airway management is an essential aspect of anesthetic therapy. The purpose of this research is to evaluate the safety and effectiveness of video laryngoscopy (VL) and fiberoptic intubation (FOI) in treating patients with cancer who have difficult airways. Materials and methods: One hundred cancer patients with anticipated problematic airways participated in prospective randomized research. Two sets of patients were created: Group A received FOI, while Group B received VL. Intubation success rate, time to successful intubation, number of tries, and consequences such hemodynamic instability, hypoxia, and mucosal damage were all noted. For analysis, arbitrary values were used. With a significance threshold set at p < 0.05, statistical analysis was carried out using the chi-square test for categorical data and the t-test for continuous variables.  Results: The VL group had a shorter time to successful intubation (mean 45 ± 10 seconds) than the FOI group (mean 60 ± 15 seconds, p < 0.05). The VL group had a greater first-attempt intubation success rate (92%) than the FOI group (85%, p = 0.03). The groups' incidence of complications were similar; mucosal damage was seen in 8% of FOI patients and 6% of VL cases (p = 0.45). The VL group had somewhat better patient satisfaction levels (9.0 ± 0.5) than the FOI group (8.5 ± 0.7).  Conclusion: When it came to challenging airway management for cancer patients, video laryngoscopy outperformed fiberoptic intubation in terms of intubation time and first-attempt success rates. Given their comparable safety profiles, VL is a better choice for clinical settings. To validate these results in broader groups, further investigation is necessary.