Background: Perioperative Respiratory complications are usually encountered by most patients undergoing surgical procedures by using endotracheal tube or laryngeal mask airway under general anaesthesia. They are the major cause of morbidity, mortality, prolonged hospital stay and increased cost of care. The objective of the present study was to determine the perioperative respiratory of laryngeal mask airway and endotracheal intubation at Muhimbili National Hospital. Methods: This was a hospital based prospective comparative study. The minimum sample of 137 patients who met the inclusion criteria were recruited into the study. Target populations were patients admitted for elective surgery at Muhimbili national Hospital. A structured questionnaire was used to collect variables being measured. The Data entry and analysis was handled using SPSS version 20.0. Proportion was calculated for all categorical variables. Categorical data were analysed using Chi-square test, values <0.05 was considered statistically significant. Results: Out of 137 patients who had elective surgery by anaesthesia with ETT or LMA 70 (51.1%) were put on ETT while 67 (48.9%) were put on LMA. Desaturation was observed in more than half (53%) of patients who were put in ETT group as compared to those under LMA (14%) with P <0.001, Similarly cough was observed in more than half of patients who received ETT (53%) compared to 29% patients who received LMA with P =0.004. Conclusion: There were lesser proportions of cough and desaturation among LMA patients when compared to ETT patients. LMA should be used as alternative to ETT in patients undergoing surgeries under general anaesthesia. Furthermore further studies should be delpoyed inlarger sample and other study sites to explore factors associated with periopertive complications.