We administered Nd-YAG laser treatments in four patients aged 56 to 68 years for severe tracheal stenosis, the tracheal diameters varying between 2.5 and 5 mm. These patients were all dyspneic at rest with talking or dressing and their peak flows ranged from 8% to 36% of predicted. They were not felt to be candidates for surgical excision. Immediate palliative relief was achieved in all patients and lasted two to four months after a single treatment in three patients. One patient died three weeks after laser treatment due to respiratory failure from underlying emphysema. There were no complications of laser therapy. Postlaser therapy the tracheal diameter in each patient was at least 9 mm and peak flow improved to between 25% and 76% of predicted. The results suggest that laser treatment may be beneficial in cases of severe tracheal stenosis.