OBJECTIVE We report two cases in which spiral CT with three-dimensional (3D) reconstruction was used to evaluate abnormalities of the trachea and bronchi. METHODS Two patients with known airway abnormalities, one with a carinal tumor and the other with a postoperative bronchial stenosis, had spiral CT of the chest performed. Images were reconstructed in the coronal plane as well as using a curved planar reformat and shaded surface display. RESULTS Spiral CT with 3D reconstruction provided excellent anatomic definition of the central airway abnormalities. In our two cases the information provided was used in both the clinical assessment and treatment planning of the patients. CONCLUSIONS Spiral CT was useful in the evaluation of two patients with central airway abnormalities. Further investigation into applications of spiral CT for the evaluation of the central airways appears warranted.