Abstract: Introduction- As we know that form follows function, the altered nasorespiratory function can lead to altered craniofacial growth. This predisposes to mouth breathing, OSA, adenoid hypertrophy which are a matter of grave importance today. Many orthodontic procedures may lead to reduced lower airway space if underlying conditions are not paid enough attention to. This forces the orthodontist to be more precise in their diagnosis and treatment planning especially planning formulated in accordance with obstructive sleep apnoea. The early diagnosis and early intervention of these conditions can prevent more severe associated problems. There are multiple evaluations of airway status undertaken by anesthetist and ENT surgeon some of which may benefit orthodontist for timely intervention. These methods include roentgenograms, CT, CT bronchography, virtual bronchoscopy, MRI, 3D printing, Ultrasonography, Nasal endoscopy, rhinomanometry. CBCT and lateral cephalogram are the most commonly used diagnostic tool for airway analysis. The reliability of lateral cephalogram in the analysis of airway has been questioned several times in the past few years which puts up a need for evaluation of the technique and its reliability. Objective- The aim of this article is to review all those literatures that relate to upper airway analysis using Lateral cephalogram to those of CBCT scans and to evaluate the reliability of lateral cephalogram Conclusion- Lateral cephalogram can be used as an initial diagnostic aid for the analysis of airways. Although the three-dimensional airway is analysed using two-dimensional technique it is nonetheless an appropriate diagnostic tool for airway analysis.