We conducted a randomised trial comparing the self-pressurised air-QTM intubating laryngeal airway (air-Q SP) with the LMA-Unique in 60 children undergoing surgery. Outcomes measured were airway leak pressure, ease and time for insertion, fibreoptic examination, incidence of gastric insufflation and complications. Median (IQR [range]) time to successful device placement was faster with the air-Q SP (12 (10�15 [5�18])) s than with the LMA-Unique (14 (12�17 [6�22]) s; p = 0.05). There were no statistically significant differences between the air-Q SP and LMA-Unique in initial airway leak pressures (16 (14�18 [10�29]) compared with 18 (15�20 [10�30]) cmH2O, p = 0.12), an airway leak pressures at 10 min (19 (16�22 [12�30]) compared with 20 (16�22 [10�30]) cmH2O, p = 0.81); fibreoptic position, incidence of gastric insufflation, or complications. Both devices provided effective ventilation without the need for airway manipulation. The air-Q SP is an alternative to the LMA-Unique should the clinician prefer a device not requiring cuff monitoring during anaesthesia.