The trachea is a ventilatory structure that extends up to the larynx and down to the bilateral main bronchi, with a total length of 10-13 cm. The trachea is covered with 20-22 cartilaginous rings in a “C” shape. Tracheal tumors account for 0.5-1% of respiratory system tumors, most of them are malignant, and their pathological types mainly include squamous epithelial carcinoma, adenoid cystic carcinoma, carcinoid carcinoma, mucosal epidermis-like carcinoma, etc. The clinical symptoms of patients with tracheal tumor appear at different times, and most patients have late symptoms. In the early stage, cough is the main complaint, and as the tumor grows, patients gradually show shortness of breath and dyspnea, and when the tumor occupies more than 2/3 of the tracheal lumen, cyanosis and respiratory trismus may appear. Bronchoscopy is a necessary tool to clarify tracheal tumor, which can not only directly observe the morphology, texture and scope of tumor, but also collect biopsy specimens to clarify the diagnosis and help the formulation of treatment plan. Bronchoscopy can help and guide the tracheal intubation to cross the tumor obstruction site and obtain good ventilation. The treatment of tracheal tumor is based on surgery, and once the diagnosis is clear, surgery should be considered first. As the length of tracheal resection is limited to a certain extent, surgical treatment is still limited to a certain range of allowable resection. The choice of surgical case depends mainly on whether the lesion can be completely removed and whether the airway can be maintained after resection. The purpose of surgery in tracheal surgery is to remove the lesion, relieve the obstruction and reconstruct the airway. The edge of tracheal tumor resection is better than 0.5 cm from the tumor. If the trachea is excised too long, the tension of the anastomosis will increase and affect the healing of the anastomosis. At present, the internationally accepted maximum length of resection should not exceed 50% of the trachea length, and in adults, the resection should be within 6 cm at a time. After resection, end-to-end anastomosis should be performed, and the caliber of the anastomosis should be as similar as possible to prevent postoperative anastomotic stenosis. This is a case of tracheal tumor that we treated. The patient was seen for dyspnea, and tracheoscopy revealed a tumor in the lower trachea, which recurred after tracheoscopic trap treatment, and one month later the tumor grew again and obstructed the trachea causing dyspnea. We took trachelectomy end-to-end anastomosis, and the pathology suggested that the tracheal tumor was fibroma. One year postoperative follow-up, the patient had a patent trachea and no tumor recurrence was observed. CT lower tracheal tumor Tracheoscopy photo Intraoperative resection of tracheal tumor Postoperative tracheal patency