Ventilatory management of tracheal reconstruction surgery may require sophisticated anesthetic techniques. Most airway problems that occurred during the tracheal surgery can be prevented by passing an endotracheal tube of small size through the tracheal narrowing or locating a normal endotracheal tube just above the stenotic lesion. However, in case of high tracheal stenosis sited near the vocal cord, it is difficult to manage airway using a cuffed endotracheal tube because of high possibility of injury of the vocal cord, shallow placement of the tube and inability to apply positive pressure ventilation. The laryngeal mask airway has been used as an efficient ventilatory device in this situation. We report one case of high tracheal stenosis requiring end to end anastomosis, where airway management was successful without any complications using the proseal laryngeal mask airway (PLMA).