The paper describes a rare clinical case of successful surgical treatment in a patient with metachronous tracheal cancer 2 years after left-sided pneumonectomy and mediastinal radiotherapy. Tracheal surgery after prepneumonectomy is shown to be difficult and to require the coordinated work of a surgical team and an anesthesiologist and the meticulous planning of a surgical intervention. The obligatory component of surgery must be to cover the tracheal anastomotic suture line with pedicled plastic materials.