Nasopharyngeal airway insertion is simple, provides good ventilation, maintains hemodynamic stability, is well-tolerated, inexpensive, and readily available, leading to its increasing use in anesthesiology and other departments. However, healthcare professionals should be aware of potential complications such as nausea, vomiting, aspiration, and nasal mucosal injury. While proper placement and fixation of the nasopharyngeal airway can reduce the incidence of nausea, vomiting, and aspiration, nasal mucosal injury is unavoidable.Even when inserted by skilled operators, nasopharyngeal airways can still cause nasal mucosal damage in 4.7% of patients. Furthermore, it cannot be guaranteed that every operator in clinical practice will possess this level of skill, meaning the actual incidence of nasal mucosal damage is likely to be even higher. While nasal mucosal damage is not life-threatening, it increases the risk of infection and reduces patient satisfaction.Therefore, we believe that improvements to nasopharyngeal airways should focus on reducing complications. Improving performance, optimizing structure, reducing complications, and simplifying operation are the future directions for the development of improved nasopharyngeal airways, and the clinical effectiveness of these improved airways still requires further clinical trials for verification.