BACKGROUND: Insertion of supraglottic airway devices (SADs) can be technically easier to perform for novices than endotracheal intubation (ETI), particularly in a situation with difficult airway management. We evaluated the efficacy and usefulness of the ProSeal laryngeal mask airway (PLMA), I-gel, and ETI when used by novices in a simulated difficult airway scenario. METHODS: A total of 109 novices participated in a brief educational session about PLMA, I-gel and ETI. The sequence of the airway devices was randomized for each participant using a computer-generated random table, and the devices were inserted in a manikin with restricted cervical spine movement. A nasogastric (NG) tube was then inserted through each SAD. In the case of ETI, the NG tube was inserted through the manikin's nostril. RESULTS: The success rate at the first insertion attempt was 93.6% for the I-gel compared with 72.5% for the PLMA and 19.3% for ETI. The I-gel also enabled a significantly shorter insertion time than the PLMA (I-gel 26.3 ± 21.9 sec and PLMA 36.0 ± 35.4 sec). The novices showed high success rates for NG tube insertion using SADs (PLMA 96.3% and I-gel 98.1%) compared with ETI (24.8%). CONCLUSIONS: We found that the I-gel provided a better first time success rate and a shorter insertion time than PLMA and ETI, which indicated that the I-gel may be preferable for difficult airway management by novices.