Endotracheal tube-induced coughing is acommon problem in most patients during emergence from general anesthesia, which can result in hypertension, increased intraocular pressure, elevated intracranial pressure, tachycardia, arrhythmia, bronchospasm, and disruption of surgical wounds. Objective Inflate the endotracheal tube cuff with lidocaine will make it a reservoir of local anesthetic, which can diffuse across the cuff and anesthetize the mucosa thus diminishing coughing and preventing endotracheal tube-induced complications such as sore throat, hoarseness, dysphonia and dysphagia. Content This review describes the mechanism of intracuff lidocaine (ICL) and thedevelopment of ICL. The effectiveness and safety of ICL for endotracheal tube-induced coughing, and its comparison with other airway management methods,will be fully discussed. Trend ICL will be wildly used in patients under general anesthesia. ICL has many benefits for patients prior toextubation.