Objective To introduct the experience of anesthesia and operation of complicated resection of the trachea,and promote techniques of anesthesia and operation of the tracheal resection and reconstruction. Methods Reviewing the anesthetic and operative process of 5 cases of tracheal resection and reconstruction,dis-close difficulties with corresponding methods,postoperative follow-up,summarizing suitable measures for succeed of large-segment resection and reconstruction of the trachea. Results In 4 cases of patients with benign stricture of the trachea,3 cured with good quality of life in 2 - 5 years follow-up, 1 case of resection of 6 cm trachea with one-stage reconstruction dead from anastomotic fistula and infection of mediastinum. One case with malignancy re-section of 8 cm trachea and reconstructed with Zhao's artificial trachea dead from remote metastasis one and a half year later. Conclusion The complexity of tracheal operation is with big different from case to case,therefore, preoperative precisely evaluation with careful individually protocol of anesthesia and operation,and good coopera-tion between surgeon and anesthesiologist are critical.