Orthognathic surgery requires the upper and lower jaw occlusal alignment, where anesthesia intubation is commonly adopted through nasotracheal intubation. In order to prevent the endotracheal tube from falling off, a silk thread is often used to fix the endotracheal tube on the nasal columella. The articles reports one case of endotracheal tube cuff leakage caused by endotracheal tube suture during orthognathic surgery. The patient had air leakage from the endotracheal tube during the operation. Accordingly, the oropharynx was packed with gauze, and the infusion pump continuously pumped the air into the cuff pump. The patient completed the operation successfully. At the end of the operation, the patient was awaked and extubated, without aspiration, and the respiratory sounds were clear in both the lungs on lung auscultation. The patient was discharged five days after the operation.