Hypoglossal nerve injury is an uncommon complication following endotracheal intubation. A transoral procedure in-cluding endotracheal intubation may result in hypoglossal nerve compression at the lateral margin on the hyoid bone and inner mandibular margin at the tongue base. A 50-year- old patient undergoing rotator cuff repair developed a tran-sient unilateral postoperative hypoglossal nerve injury follo-w-ing uncomplicated endotracheal intubation for general ane-s-thesia. The following day the patient complained of diffi-culty with tongue movement and buccal manipulation of food, and had slurred speech. An electrophysiologic assess-ment confirmed a diagnosis of unilateral hypoglossal nerve palsy. The symptoms resolved spontaneously and completely by 6 weeks. The possible etiology of the injury is discussed, and related literatures are reviewed. (J Korean Acad Rehab Med 2009; 33: 246-248)