In order to overcome the influence of stray light and impurity on the image of video laryngoscope, we designed an optical structure by using TracePro, a simulation software, to imitate optical path status. Images are captured by CMOS sensor which has the size of 4.5 mm×18 mm and the pixel size is 1.75 μm×1.75 μm. The sensor is placed in the elbow of the laryngoscope, and the elbow has the size of 9 mm×10 mm. As a result, the video laryngoscope could meet the requirements, including wide viewing angle (80°), short focal length (2.8 mm), long working distance (10 cm), and least impurity. In the test, the image was clear and there was no facula or impurity in the condition of required illumination, and thus stray light and image impurity were eliminated and the image quality was improved.