Surgical resection of primary tumors of the cervical or upper thoracic trachea is usually carried out by performing the resection over a cuffed endotracheal tube which has been passed into the distal trachea or a main stem bronchus.1-6 However, location of a tumor at/or close to the carina poses problems in adequate ventilation during the period of resection. The use of extracorporeal circulation to support cardiopulmonary function during resection of the primary tracheal tumor has been reported twice previously. Woods7 in 1961 used this method for removal of a recurrent cylindroma of the distal trachea. Nissen8 also in 1961 used extracorporeal circulation and hypothermia to resect a malignant adenoma of the distal trachea. The purpose of this communication is to report a third case of cylindroma of the distal trachea which was successfully resected with this technique, with utilization of Marlex mesh for tracheal reconstruction. Report of