Van Zundert and colleagues argue that although supraglottic airway devices (SADs) have evolved over time, both first- and second-generation devices are still fundamentally limited by blind insertion. Even newer second-generation SADs, which include features such as higher seal pressures and gastric drainage channels, rely on indirect clinical signs to judge correct placement rather than direct visualization of airway anatomy. As a result, malpositioning remains common, which can impair ventilation, reduce airway seal quality, and increase the risk of complications such as airway obstruction or aspiration. The authors contend that these limitations justify the need for a third-generation supraglottic airway device. They propose that this new generation should enable direct vision placement, for example through integrated cameras and illumination that allow real-time visualization of key anatomical landmarks during insertion. Such visualization would permit immediate correction of suboptimal positioning and more reliable confirmation of proper placement. Although no specific device is presented, the article frames this as a conceptual and technological step forward, comparable to the adoption of ultrasound guidance in other procedures, with the potential to improve safety, accuracy, and consistency of supraglottic airway management.