We recently experienced a case of tracheal obstruction in tracheostomy state. The patient was 23 year old female who had been suffered from decannulation difficulty for over 2 years. Air tracheogram and laminogram disclosed tracheal obstruction at just proximal portion of tracheostoma. General anesthesia started through tracheostoma at first and was replaced by pre-inserted per oral intubation tube after resection of obstruction segment. T-shaped neck incision was made and cervical trachea mobilized . Obstructed segment [1.5cm] was resected circumferentially including tracheostomy and primary end to end anastomosis was performed. Total resected trachea was 2.5 cm in length. Postoperatively the patient`s neck was maintained in flexion state to reduce tension of anastomotic site. Extubation was delayed until 4th POD. due to right lower lung atelectasis. Hoarseness was noted and it`s probably due to intraoperative resection of the recurrent laryngeal nerve. Otherwise, she was uneventful and discharged on her 32nd POD. without dyspnea. [KTCS 1983;4:555-558]