Recent studies reported laryngeal mask airway (LMA) ventilationshowed the poorest outcome compared with Bag-valve mask (BVM) and endotracheal intubation (ETI) in out-of-hospital cardiac arrest (OHCA) patients. However, emergency medical service system (EMSS) is different in country to country, We conducted this study to determine association between airway management techniques and outcomes after OHCA in Korea that EMSS is single-tiered and prehospital advanced airway management is not widely provided. We used the CAVAS (cardiovascular disease surveillance), Korean national OHCA cohort database. Eligible patients were all adult OHCA patients who attempted resuscitation by level 1 EMTs (EMT-intermediate level) transported to ED, with presumed cardiac etiology, from January 2006 to December 2012. We exclude that resuscitation discontinued after ED arrival without ROSC, and we couldn`t know patients` outcome and which airway management technique was used. All patients were divided into three groups by airway management techniques (BVM, LMA, and ETI) before ED arrival. The primary outcome was sustained ROSC rate, the secondary outcomes were survival to admission, survival to discharge, and good neurological outcome. We compared outcomes between each airway group using multivariable logistic regression, adjusting for sex, age, initial shockable rhythm, witnessed, bystander CPR, AED used, metropolitan, level of ED and time interval (call to scene, scene CPR, call to CPR, scene to hospital) Of 145,785 patients with OHCA, we enrolled 29,067 (19.9%). ETI and LMA were performed in 1,081 (3.7%) and 1,271 (4.4%), respectively. In the full multivariable models, adjusted sustained ROSC was similar for ETI and BVM (OR,1.102; 95% CI, 0.803-1.512). Adjusted sustained ROSC was also similar for LMA and BVM (OR, 1.075; 95% CI, 0.825-1.4). In Korea with single tiered EMSS, advanced airway provided to OHCA patients by EMT-intermediate didn`t show any difference in terms of sustained ROSC rate compared with BVM.