Objective To compare the clinical effectiveness of superimposed high frequency jet ventilation and high‑frequency jet ventilation in airway management by fiberoptic bronchoscopy (FOB) under general anesthesia. Methods According to the random number table method, 40 patients who were scheduled for painless FOB were randomly divided into two groups (n=20): high‑frequency jet ventilation group (group H) and a superimposed high frequency jet ventilation group (group S). After anesthesia induction, group H underwent high‑frequency jet ventilation, while group S received superimposed high frequency jet ventilation after general anesthesia with laryngeal mask. Their heart beat, mean arterial pressure (MAP), and pulse oxygen saturation (SpO2) as well as pH value, partial pressure of arterial oxygen (PaO2) and arterial carbon dioxide partial pressure (PaCO2) of arterial blood gas analysis were recorded after patients entered the operating room (T0), 15 min (T1) and 30 min (T2) after ventilation, and immediately after recovery of spontaneous breathing (T3). The concentration of blood glucose, C‑reactive protein (CRP), cortisol and interleukin‑6 (IL‑6) were measured. The number of patients whose operation was suspended due to end‑tidal carbon dioxide partial pressure (PETCO2)>80 mmHg (1 mmHg=0.133 kPa) were recorded. Results There was no hypoxemia in the two groups. Compared with those at T0: both groups presented increases in heart beat at T2 and T3 (P<0.05) and increases in SpO2, PaO2 and IL‑6 at T1 to T3 (P<0.05); group H showed increases in MAP, blood glucose and cortisol at T2 and T3 (P<0.05), increases in CRP at T3 (P<0.05), decreases in pH values and increas es in PaCO2; group S showed increases in MAP, blood glucose and cortisol at T3 (P<0.05), and decreases in pH values at T2 (P<0.05). Compared with group H: group S presented decreases in heart beat and MPA at T2 (P<0.05), increases in pH values and decreases in PaCO2 at T1 to T3 (P<0.05), decreases in blood glucose, cortisol and IL‑6 at T2 and T3 (P<0.05) and decreases in CRP at T3 (P<0.05). There were no statistical difference in the above indicators at other time points (P>0.05). There were three cases in group H and no case in group S with suspended surgery due to PETCO2>80 mmHg. Conclusion The superimposed high frequency jet ventilation is superior to high‑frequency jet ventilation in the airway management of painless fiberoptic bronchoscopy.