Introduction: Tracheal surgery is the lastly developed and one of the most challenging parts of thoracic surgery. So, we have conducted a retrospective study of our experience in the treatment of tracheal surgical diseases. Methods: The records of tracheal diseases patients were reviewed retrospectively. The patients were grouped into 2. The first is the curative surgery group who underwent trachea resection, while the second is the palliative interventions group who underwent bronchoscopy, endobronchial lesion resection, dilatation and/or stent placement. Results: Forty-eight patients underwent 51 operations during a four-year period. Overall 47% of the interventions were in curative resection group and 53% were in bronchoscopic palliation group. Twelve percent of the patients [16% of resection group, 7% of bronchoscopic palliation group] were complicated postoperatively. Conclusion: Major airway reconstruction is the best way of managing airway pathologies with high success rate and low morbidity. Palliative bronchoscopic interventions are chosen if the lesion is not resectable, or patients have high risk of comorbidity or failed to accept the major operation.