Abstract: Objective：To investigate the clinical features, diagnosis and surgical treatment of primary malignant tumors of the trachea and main bronchus. Methods：Clinical data of 35 cases with primary malignant tumors of the trachea and main bronchus in Zhongshan Hospital, Fudan University between January 2005 and December 2015 were analyzed retrospectively. Results：The clinical symptoms were cough, sputum, bloody sputum, hemoptysis, shortness of breath, chest tightness, thoracalgia, and fever. There were 13 cases (37.1%) proved to be misdiagnosed in the early stage. All patients underwent surgical treatment without complications, and 3 patients were received postoperative radiotherapy. Among the 31 cases received postoperative followup, 26 cases survived, 5 cases died.The average diseasefree interval was (34±16.2) months (16 to 49 months) and the median survival time was 50 months (16-138 months). Conclusions：Primary malignant tumors of the trachea and main bronchus without special clinical manifestations are easy to be misdiagnosed so that early bronchoscopy and chest CT examination are necessary. Active surgery treatment for primary malignant tumors of the trachea and main bronchus can achieve generate good prognosis.