Tracheal neoplasms are rare tumors that are detected in the late stages of the disease after the development of tracheal stenosis and concomitant complications. This presents difficulties in examining and treating these patients. Subjects and methods. The authors present a 50-year experience in the diagnosis and treatment of 1062 patients with both primary (46.2%) and secondary (53.8%) tracheal tumors when cancers of the lung, larynx, and thyroid or mediastinal tumors spread to the trachea. They propose a classification to determine the extent of tumors of the trachea and an algorithm for diagnostic and therapeutic procedures, depending on the degree of its stenosis and on the development of concomitant complications. Surgery and combined treatment were performed in 773 patients; radiotherapy only was used in 152 patients. During surgical treatment, 69.8% of the patients underwent circular resection of the trachea, and the others had marginal or wedge resection. Both isolated and combined tracheal resections were done in combination with resection or complete removal of the neighboring organs (the lung, larynx, thyroid, etc.). The original methods developed at the Russian Research Center of Roentgenology and Radiology and the well-known existing ones were used to repair the trachea after extensive and combined resections. Additional postoperative radiotherapy was performed in 56.8% of the patients. Results. The application of a differentiated approach when performing complex diagnostic and therapeutic procedures in patients with tracheal tumors will be able to reduce the frequency of postoperative complications from 5.9 to 1.6%. Postoperative radiotherapy improved long-term treatment results. It turned out to be most effective in treating adenoid cystic carcinoma: if the 5- and 10-year survival rates after surgical treatment only were 78.3±6.1 and 45.9±7.9%, those after combined treatment were 92.0±3.9 and 77.1±6.5%, respectively. Conclusion. Problems in the diagnosis and treatment of tracheal tumors are mainly associated with the degree and extent of upper airway obstruction and, accordingly, with the complexity of diagnostic and therapeutic measures. Radiotherapy should complement surgical treatment for malignant tracheal tumors.