Background: The objective of the study was to compare the study on the endotracheal tube cuff pressure changes between supine and prone in patients undergoing prone position surgeries. Materials and Methods: After obtaining approval from institutional ethics committee, this study was conducted in Department of Anesthesiology at Sri Manakula Vinayagar Medical College and Hospital, Puducherry between November 2015 and August 2017. A total of 60 patients who met the inclusion criteria were enrolled into study and prepared for General Anesthesia in prone position. After induction, the cuff pressure was recorded with head in neutral, flexed and extended position; these parameters were noted with patient in supine position and then in prone position. Results: There was no significant difference in mean cuff pressure at neutral posture between supine and prone position. Mean cuff pressure was increased after flexion and extension from neutral posture in both supine and prone position. At flexed posture mean cuff pressure was higher in supine position and at extended posture mean cuff pressure was higher in prone position. Conclusion: With this study we concluded that the supine or prone position has no influence on the cuff pressure when the head is in neutral position. In the supine position flexion of the head should be avoided because it leads to higher cuff pressure than with the head flexed in prone position. Similarly extension of the head should be avoided in the prone position.