Tuberculous tracheobronchial stenosis is caused by damage and fibrosis of the bronchial cartilage. It is often overlooked and misdiagnosed clinically as airway stenosis in asthma or chronic obstructive pulmonary disease due to recurrent infections or persistent cough. Fiberoptic bronchoscopic intervention is an option, which includes laser ablation, balloon dilatation and stent placement. Some patients require complex bronchoplasty or tracheobronchoplasty, but such procedures are difficult, with high mortality and complication rates [12-14]. Jin Feng, Department of Thoracic Surgery, Shandong Chest Hospital, Shandong Province, China Left main bronchus resection and reconstruction (LMBRR) is a complex surgical procedure, and Ragusa [12] reported four cases of LMBRR, in which one patient had tuberculous left main bronchus stenosis (LMB). Three balloon dilatations were attempted under rigid bronchoscopy 6 months prior to surgery. The operation was performed with right-sided double-lumen endotracheal intubation and left-sided posterior lateral incision of the IV intercostal space into the chest. Intraoperatively, the inferior pulmonary ligament was severed, the pericardium was completely dissected, and a better freeing around the pulmonary hilar vessels was performed. These measures allow the lung to rise a few centimeters and safely resect more than 3/4 (4 cm) of the length of the LMB. The anastomosis was closed with a tension-free suture technique, a prerequisite for successful healing. Intraoperative distraction of the aortic arch was performed to completely expose the tracheal rongeur and facilitate anastomotic reconstruction of the tracheal dissection. This patient was followed up for more than 30 months and developed only mild asymptomatic stenosis. There are two main methods of surgical access: 1) an anterior approach to the chest through a median sternotomy, and 2) a posterolateral lateral approach to the chest through the left side. The anterior median incision is probably the best and facilitates proximal anastomosis but is more invasive if considered purely in terms of intact exposure of the rupture; for the sake of the disease involved in the distal portion of the left main bronchus and for better postoperative management, the authors believe that the IV intercostal entry distal to the chest through the left posterior lateral incision for the LMBRR is a wiser choice.