The rarity of primary tracheal tumours makes research into their natural history and treatment very difficult. Diagnosis is often made too late for cure. Palliation has improved with the introduction of laser resection, brachytherapy and stents. Squamous cell carcinoma may have a better prognosis in the trachea than in the lung. It has been assumed that surgery is the treatment of choice and up to 50% of the trachea can be resected with modern techniques. However, several of the largest surgical series have used mostly post-operative radiotherapy and really represent the results of combined therapy. High dose radiotherapy may achieve cure in some cases. Prospective studies of the relative merits of surgery and radiotherapy are urgently needed. The British Thoracic Society Research Committee is launching a national study at the present time.