Ludwig's angina and odontogenic deep neck space infections represent high-risk scenarios for anaesthesiologists, as airway compromise may develop despite initially preserved spontaneous breathing. We report a 41-year-old woman with no relevant comorbidities who presented with a five-day history of odontogenic right-sided neck swelling, fever, odynophagia, dysphagia, muffled voice, and mild discomfort in the supine position. She was breathing spontaneously on room air with an oxygen saturation of 98%. CT neck demonstrated a right submandibular collection measuring 3 × 0.6 cm, multiple right sternocleidomastoid (SCM) intramuscular collections, and bilateral deep cervical lymphadenopathy. Leftward tracheal deviation was identified on clinical imaging review. On Day 0, emergency drainage was performed under general anaesthesia. C-MAC video laryngoscopy revealed a Cormack-Lehane grade 1 view; the trachea was intubated on the first attempt with rocuronium 1.2 mg/kg, without complication. The patient was maintained intubated in the ICU for approximately 24 hours and extubated following cuff-leak testing, corticosteroid pre-treatment, and multidisciplinary team reassessment. On Day 5, a second general anaesthetic was required for repeat drainage; again, grade 1 direct laryngoscopy, first-attempt intubation, and immediate post-procedure extubation were achieved. The pus culture grew Streptococcus agalactiae, susceptible to levofloxacin, vancomycin, and amoxicillin/clavulanate. Total antimicrobial therapy comprised seven days of intravenous therapy followed by 14 days of oral amoxicillin/clavulanate, for a total course of 21 days. The patient was discharged on Day 13 in stable condition. This case highlights that the absence of stridor or hypoxaemia does not eliminate significant airway risk in deep neck infection. Muffled voice, pain-limited oral assessment, supine discomfort, multi-compartment collections, SCM involvement, and tracheal deviation require structured difficult-airway planning, surgical airway readiness, planned extubation, and repeat airway reassessment for subsequent procedures.