Endotracheal tubes (ETTs) utilizing high-volume, low-pressure cuffs lower the risk of tracheal wall injury, requiring less pressure to provide a seal. Recently introduced tapered ETT cuffs, which show a lower propensity for fluid leakage, provide another ETT option. Aeromedical transport presents a challenging environment for ETT cuff management and requires diligent monitoring to maintain pressure within the recommended range. The pressure measured in the cuff is assumed to be equal to the pressure exerted on the tracheal wall (TW). We performed a bench study to evaluate this correlation at sea level and simulated altitude. Mean TW pressure and cuff pressure were compared using Students t-test. Statistical significance was defined as p 0.05. When using air in the ETT cuff, TW pressure differences were statistically significant between baseline and at altitude with all ETTs but not between baseline and at sea level after descending from altitude. When using saline in the ETT cuff, TW pressure differences with the 7.5 high-volume, low-pressure cuff and 8.0 TaperGuard cuff were statistically significant at altitude and back at sea level, as compared to baseline. Cuff pressure differences with saline in all ETTs were not statistically significant. Comparing TW pressure and cuff pressure, differences were statistically significant at all conditions with all ETTs. The use of saline provided the highest baseline pressure but had the lowest pressure variation, while using air provided the highest pressure at altitude and the largest pressure variation from baseline. Due to lack of ability to measure pressure, use of saline in the ETT cuff is discouraged. Maintaining cuff pressure 30 cmH2O is imperative to minimize TW pressure.