Objective To explore the clinical effect of SaCoVLMTM video laryngeal mask airway and Ambu®Aura‑Gain laryngeal mask airway combined with fiberoptic bronchoscopy (FOB) for airway management in children under general anesthesia. Methods According to the random number table method, 100 patients aged 1‒6 years, classified as American Society of Anesthesiologists physical status (ASA) Ⅰ or Ⅱ and Mallampati grade Ⅰ or Ⅱ, were divided into two groups (n=50): the SaCoVLM™ laryngeal mask airway‑guided intubation group (SaCo group) and the Ambu®Aura‑Gain combined with FOB group (Ambu group). In the SaCo group, tracheal intubation was performed directly under the guidance of video laryngeal mask airway. In the Ambu group, tracheal intubation was guided by Ambu®Aura‑Gain laryngeal mask airway combined with FOB. General data of two groups were recorded. Primary outcome is the total time to successful tracheal intubation. Secondary outcomes include the first‑attempt success rate of intubation, time of laryngeal mask insertion, number of laryngeal mask insertion, leakage pressure, time of intubation, glottis exposure grade, the hemodynamic variables [at admission to the operating room (T0), before laryngeal mask airway insertion (T1), immediately after laryngeal mask airway insertion (T2), before intubation (T3), 1 minute after intubation (T4), 2 minutes after intubation (T5), 5 minutes after intubation (T6), and after extubation (T7)], the retention time of laryngeal mask airway, extubation time, and complications associated with laryngeal mask placement and tracheal intubation (including laryngeal mask airway and tracheal tube surface blood staining, choking, hypoxemia, sore throat, laryngospasm, dysphagia, hoarseness, etc). Results There was no significant difference in general data between the two groups (all P>0.05). Compared with the Ambu group, the SaCo group had shorter the total time of successful tracheal intubation and the time of intubation (all P<0.05), a higher first⁃attempt success rate of intubation and a higher leakage pressure (P<0.05), a longer time for laryngeal mask airway insertion (P<0.05) and a lower heart rate at T4 (P<0.05). Laryngeal mask airway was successfully inserted in children at one time. There were no significant differences in the glottis exposure grade, the time of laryngeal mask insertion and extubation time between the two groups (all P>0.05). There was no significant difference in heart rate at T0‒T3 and T5‒T7, mean arterial pressure and pulse oxygen saturation at each time point between the two groups (all P>0.05). After the laryngeal mask airway was removed, there was no significant difference in the incidence of blood staining on the laryngeal mask surface and sore throat between the two groups (all P>0.05). There were no related complications such as tracheal tube surface blood staining, choking, laryngospasm, hypoxemia, dysphagia, and hoarseness in both groups. Conclusions Compared with the Ambu®Aura‑Gain laryngeal mask airway combined with FOB, the SaCoVLMTM video laryngeal mask airway is easier to use and has a higher first‑attempt success rate of intubation. It may provide a better solution for managing difficult airway in children.