Nursing management of the patient undergoing tracheal resection and reconstruction is not well described in the literature. Over the last 25 years, nurses in the respiratory surgical intensive care unit at Massachusetts General Hospital in Boston have cared for more than 600 patients who have undergone this procedure. Using a diagnostic format, we have developed a plan of care for this patient population. In this article, the etiology of tracheal obstruction, its diagnosis and surgical correction, and nursing care of the patient after tracheal resection and reconstruction are presented.