Seventeen-year-old Hao Hao 4 months ago in the school physical examination found a shadow on the right lung, rushed to the local hospital, chest CT examination suggests that the right upper lobe of the lung patchy hyperdense shadow, consider the right lung tuberculosis, which realized that he had been coughing, coughing up sputum for half a month, suffering from a cold is not. After that, he was transferred to the local tuberculosis control hospital and began to receive hospitalization. Two months ago, Hao Hao underwent bronchoscopy, which indicated that he had bronchial tuberculosis, and was discharged from the hospital after bronchoscopic freezing and argon gas knife and microscopic drug injection. After discharge, he continued to take anti-tuberculosis and hepatoprotective drugs. Recently, Hao Hao’s cough and chest tightness symptoms worsened again, and he was transferred to the hospital for further treatment. After admission, tracheoscopic treatment was performed under general anesthesia. The flexible scope was inserted through the mouth, the mucous membrane of the upper part of the trachea was rough, and caseous necrosis could be seen in the anterior opening of the right upper lobe and the anterior opening, so carbon dioxide freezing and thawing, laser cauterization, and medication injection under the scope were given to the caseous necrosis, and the lumen of the trachea was smooth after the above treatments. Roughness of the mucosa of the upper part of the trachea Opening of the right upper lobe Anterior part of the right upper lobe Anterior part of the right upper lobe (after treatment) Most of the symptoms of tuberculosis are coughing, coughing up sputum and so on, which is easy to confuse with common diseases such as bronchitis and pneumonia, and it is difficult to attract people’s attention and easy to be misdiagnosed. Bronchial tuberculosis is a special type of tuberculosis, which can appear to erode the airways in a short period of time, leading to destruction of bronchial cartilage, tuberculosis granuloma and scar tissue formation, etc., which narrows or completely occludes the airways, and it is an important reason for the increase of disability and mortality of tuberculosis in China. Studies show that about 50% of patients with pulmonary tuberculosis are combined with bronchial tuberculosis. It is very easy to miss the diagnosis if bronchoscopy is not performed in time. Therefore, during the course of anti-tuberculosis treatment, patients with pulmonary tuberculosis should undergo bronchoscopy as early as possible in order to understand the bronchial lesions and choose the appropriate treatment in time. Generally, there are 6 types of bronchoscopic manifestations: congestion and edema, ulcerative necrosis, granulomatous branching, scarring and stenosis, wall softening, and lymph node fistula. Our patient belonged to the caseous necrotic type. For caseous necrosis type tracheal splice, carbon dioxide freezing, microscopic drug injection and argon knife intervention can effectively relieve the sequelae of tracheal obstruction and tracheal stenosis.