Nasogastric tube insertion is a frequently performed procedure in the perioperative setting, allowing for gastric decompression,administration of medications.The conventional technique, involving blind insertion using anatomical landmarks, is commonly employed but can lead to difficulties and complications. This research paper aims to compare the effectiveness and safety of twodifferent positions  for nasogastric tube insertion: sniffing and RAMP  . The study will assess success rates, insertion time, and potential complications. Objectives: To compare Sniffing position with that of RAMP positionin nasogastric tube (NGT) insertion techniques among the intubated patients  with respect to first attempt success rate, time taken for insertion, and complications. Methodology: This Prospective interventional randomized controlled trial was conducted among 112 patients posted for  general anaesthesia requesting NGT insertion  at R.L. Jalappa Hospital and Research Centre, Tamaka, Kolar. Patients of either sex, confirming to the American Society of Anesthesiologists’ (ASA) physical status I or II, aged 18–60 years,  requiring NGT insertion in intubated patients were included in the study. Patients with normal airway (modified Mallampati class I or II) were included in this study. In group A -conventional “sniffing” position was obtained by placinga firm 7-cm cushion underneath the patient’s head, thus raising the occiput a standard distance from theoperating-table while the patient remained supine. In group  B - In these patients, multiple folded blankets to be  placed under the patient's upper body ( head andneck ) until horizontal alignment between the externalauditory meatusand the sternal notch is achieved . Results: The present study included total of 112 patients. In this study,first attempt success rate for NGT insertion is greater for RAMP position (75%) when compared with sniffing position (44.6%) and this difference between the groups is statistically significant (p value <0.05). It is concluded that Mean time taken for NGT insertion is less for RAMP position (45.30+-7.98)  when compared to that of sniffing position  (53.54+-10.33)and this difference is statistically significant. From the study, it is concluded that RAMP position of NGT insertion has got fewer complications (25% of study subjects) when compared with that of Sniffing position (46.42% of study subjects) and this difference is statistically significant (p value <0.05).