Objective To study the effect of surgical treatment of primary tracheal tumor. Methods The data of 18 patients with primary tumor of trachea resected at PUMC Hospital from March 2001 to October 2009 were reviewed retrospectively. There were 14 cases of sleeve tracheal resection, 3 cases of local enucleation, 1 case of carina reconstruction. 2 patients underwent operation under cardiopulmonary bypass. Results Among the 18 cases, there were 7 adenoid cystic carcinomas, 3 neurilemmomas, 2 hamartomas, 1 squamous cell carcinoma, 1 myofibroblastoma, 1 pleomorphic adenoma, 1 anaplatsic large-cell lymphoma, 1 lymphoepitheloid carcinoma, and 1 mucoepidermoid carcinoma. All the patients recovered and their symptoms were alleviated obviously. Conclusions Surgery is the most effective treatment for primary tracheal tumor. The operation mode should be selected individually according to the patient's condition. Both complete resection and safety should be considered.