We think this Annals of Cardiothoracic Surgery special edition on Tracheal Surgery will be a valuable contribution to those clinicians interested in airway surgery. We have focused most on the contributions from our institution to allow the reader to know how “we do it”! As with most things in surgery, there are differences in opinion about “how to do it”. Our institution has been interested in airway surgery for over six decades. This volume reflects the evolution of our approach to airway problems and the corresponding surgical techniques to manage these problems. Many of the basic principles reach back to Hermes Grillo’s pioneering work in this field. Some of the techniques remain unchanged and have stood the test of time. Some techniques have been modified to address issues that became apparent over the course of treating patients. Some novel approaches were developed to address very specific complex problems. Finally, the future utilizing principles of regenerative medicine that someday may offer solutions to unsolvable problem. We hope the reader takes away much from this edition and finds it valuable in practice.