[Abstract] Objective Esophagotracheal fistula (ERF) is the most common type of clinical airway fistula. The aim of this paper was to investigate the efficacy and safety of peritoneal metallic stent (CZTS) to seal ERF. Methods Patients with ERF were placed with CZTS under tracheoscopy and/or X-ray fluoroscopy. 34 cases had primary esophageal tumors, 12 cases had lung cancer, and 2 cases had thyroid cancer. Results There were 52 fistulae in 48 patients with a caliber of 0.3 cm-7.0 cm. most of the fistulae were located in the middle and lower main trachea and bilateral bronchial openings. There were 2 cases of BPF and EMF, 1 case of TMF and 1 case of EPF. Fifty-two CZTS were placed (36 Y-shaped, 8 L and I each). Fifty fistulae were closed. outcome: CR 4.0%, cCR 68.0%, PR 18.0%, NR 10.0%. Median survival time was 6 months. The selection of the right shape of stent is most important. Bifurcated tracheal stents are particularly suitable for perilungal fistulae.