Airway management includes certain measures to ensure a patent pathway between a patient’s lungs and the outside environment. An obstructed airway implies that there is less availability of oxygen to the body. Humidification, nebulization and suctioning are the three essential measures of artificial airway maintenance. The aim of the study was to assess the effect of hypertonic saline nebulized suctioning on airway clearance among patients connected to mechanical ventilator. A randomized controlled trial was carried out with the sample size of 30 patients. Of the 30 samples, 15 were randomly assigned to the study group and 15 to the control group. The effect of hypertonic saline nebulized suctioning on airway clearance as estimated by the biophysiological parameters (Heart rate, SPO2, ETCO2 and ABG)showed significant difference in SpO2(p<0.001) and ABG-PO2(p<0.05).The study has shown that hypertonic saline nebulization is the cheapest, safe, effective and easiest way in maintaining the airway patency for a patient connected to a mechanical ventilator