We reported the role of endobronchial ultrasound as complement to standard diagnostic exams to better define the benign tracheal stenosis (i.e., thickness and tracheal cartilage integrity) and to plan the treatment with flexible instead of rigid bronchoscope. Under sedation and spontaneous ventilation, the flexible bronchoscope was inserted through the laryngeal mask airway that assured the ventilation. The stenosis was first resected with cold scissors and then dilated with balloon catheter. This strategy was successfully applied in five consecutive patients. Inclusion criteria for the procedure were stenosis < 1 cm in length, without tracheomalacia and with integrity of airway cartilage.