What is tracheal stenosis: The causes of tracheal stenosis include congenital (e.g., congenital abnormal tracheal development) and acquired (e.g., scar stenosis or long-term compression by peritracheal masses (e.g., thyroid masses) to the point where the tracheal wall is softened and narrowed. In recent years, tracheal stenosis caused by tracheotomy or tracheal intubation has also been increasing. Tracheal stenosis is an irreversible and progressive lesion, and the effective treatment is surgical resection of the stenotic segment and end-to-end tracheal anastomosis. Clinical manifestations of tracheal stenosis: The common symptoms of tracheal stenosis are varying degrees of dyspnea due to airway obstruction, progressive dyspnea with increasing stenosis, and wheezing during inspiration. It is often accompanied by shortness of breath, coughing and effortful coughing of sputum. It is aggravated by physical activity and increased secretions in the airways. In severe stenosis, the supraclavicular fossa and intercostal soft tissue of the upper abdomen are concurrently depressed during inspiration (trigeminal sign). Tracheal scar stenosis should be considered first in cases of previous tracheotomy and intubation with these symptoms. Treatment of tracheal stenosis: Tracheal stenosis is an irreversible, progressively aggravating lesion, and the most effective treatment is surgical excision of the lesion. Circumferential resection of the lesion with end-to-end anastomosis is the main treatment for tracheal stenosis. In cases where the stenosis is too long for resection of the lesion and end-to-end anastomosis, a tube can be built into the trachea and led out of the body through a stoma to relieve tracheal obstruction and ensure airway patency. Health guidance: Tracheal stenosis can be treated and prevented. When performing tracheotomy, avoid making too high an incision and do not injure the first cartilage ring; avoid excising too much of the anterior tracheal wall; pay attention to the proper position of the tracheal tube to avoid compression of the anterior tracheal wall by the tube; avoid overloading and stiffening the external tube of the tracheal tube; and avoid excessive inflation pressure of the tracheal tube balloon to effectively prevent tracheal stenosis or reduce its incidence. Case presentation: This is a case of a patient who came to our hospital with dyspnea 1 year after tracheotomy. CT and tracheoscopy revealed fibrous scar hyperplasia in the upper trachea with significant luminal narrowing and a minimum tracheal inner diameter of only 3 mm. the patient could not lie down and breathed in a sitting position daily. We made a cervical incision, separated the scar tissue, resected the narrowed proximal trachea and performed an end-to-end anastomosis, after which the patient’s dyspnea improved significantly. Tracheal stenosis after pneumonectomy The narrowest part of the trachea was only surgically resected.