Objective To explore how to choose the methods of intubation under anesthesia and surgery in the treatment of tracheal stenosis.Methods The clinical data of 32 patients with tracheal stenosis treated by thoracic surgery in our hospital from January 1998 to December 2018 were collected and divided into tumor group and non-tumor group according to the causes of tracheal stenosis. The methods of intubation and surgery, operative duration, intraoperative bleeding volume, postoperative intubation time, postoperative hospital stay and postoperative complications were recorded and compared between the two groups. The duration of follow-up ranged from 1 month to 20 years, and the incidence of tracheal anastomotic stenosis and the recurrence rate of the two groups were analyzed.Results The proportion of repair of tracheal defects was lower in the tumor group, while that of circumferential tracheal resection with end-to-end anastomosis and repair of tracheal defects was higher in the tumor group (P < 0.05), with no difference in surgical incision (P > 0.05). The methods of intubation and surgery for tracheal stenosis in the middle and lower segments were not different between the two groups (P > 0.05). The operative duration and intraoperative bleeding volume in the tumor group were higher than those in the non-tumor group (P < 0.05). Besides, the incidence of postoperative complications did not differ between the two groups (P >0.05).Conclusions Tracheal stenosis is often a sub-emergency or emergency condition, and surgical treatment is the most effective way to deal with it. According to the characteristics of tracheal stenosis, we can choose the methods of intubation and surgery flexibly to increase the success rate of management of tracheal stenosis.