Acquired tracheal stenosis is usually secondary to previous tracheostomy or endotracheal intubation. Dyspnea, cough, and inability to clear pulmonary secretions occur weeks to months after tracheal decannulation or extubation. Physical findings may be absent until tracheal diameter is reduced 50% or more. The diagnosis is usually confirmed by plain films or CT of the trachea. Surgical reconstruction with primary end-to-end anastomosis, endotracheal stent placement, or laser photo resection may be required.