Structures visible (seated, mouth open, tongue out, no phonation)
I — soft palate, uvula, fauces and pillars visible
II — soft palate, uvula and fauces visible
III — soft palate and base of uvula visible
IV — only the hard palate visible
Evidence
Original publication
Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Related the visibility of oropharyngeal structures to the laryngoscopic view; a higher class predicted a worse view.
Canadian Anaesthetists' Society Journal, 1985
Validation
Samsoon GLT, Young JRB. Difficult tracheal intubation: a retrospective study. Added class IV (only hard palate visible), producing the four-grade modified Mallampati score in current use.
Anaesthesia, 1987
Guideline
The modified Mallampati score is one component of airway assessment. Used alone its sensitivity for difficult intubation is limited (~50%); combine it with thyromental distance, mouth opening, neck mobility, jaw protrusion and history, and have a difficult-airway plan ready when several predictors are abnormal.
Last reviewed: 2026-09
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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.