Patients suffering from acute pulmonary edema commonly require intubation until treatments take effect. However, using rapid repeated buccal administrations of nitroglycerin ointment can almost always prevent intubation by rapidly reducing pre- and afterload as long as systolic blood pressure is adequate, and the patient is not in cardiogenic shock.  In this manuscript, 6 patients presented who were in severe pulmonary edema and needed immediate mechanical ventilatory support, but intubation was aborted in all of them by repeated rapid administration of buccal nitroglycerin ointment. Approximately a quarter of an inch of nitroglycerin ointment (nitro paste) was buccally administrated every 60 seconds as long as repeated blood pressure measurements before each repeated administration remained above 110 mmHg.  This case series is followed by a review of the literature.