Background: Tongue-related complications can be seen in suspension laryngoscopy (SL) procedures. Aims/objectives: This study aimed to detect tongue edema associated with the pressure exerted by a rigid direct laryngoscope by measuring the tongue area using ultrasonography (USG) in patients undergoing SL procedures. Material and methods: The study group included 31 patients and the control group consisted of 33 patients. Submental USG examinations of the tongue in the coronal plane were performed. In the study and control groups, the first examination (TA1) was done immediately after intubation and the second examination (TA2) was done after the surgery procedure but before extubation. The USG results regarding tongue area for both the groups were compared. Results: The study and control groups significantly differed in terms of the postoperative tongue area measurements (TA2), as well as tongue edema (based on the TA2 − TA1) values. Conclusions and significance: Direct rigid laryngoscopes may cause tongue edema in SL procedures which was demonstrated by the USG. This tongue edema can be a result of ischemia–reperfusion injury in the tongue due to the pressure exerted by a direct rigid laryngoscope. This study is the first to demonstrate the possible role of USG examination in determining the side effects of SL procedures on the tongue. Trial Registration ClinicalTrials.gov Identifier: NCT04205253.