Tracheobronchial ruptures resulting from blunt chest trauma are rare events. Depending on their anatomical location and extension they may be nearly asymptomatic and escape early diagnosis, on the other hand they may induce an acute life-threatening situation with dramatic symptoms. The awareness of the different clinical and radiological findings may point to this lesion, the definite diagnosis, however, is made by bronchoscopy. A rapid surgical reconstruction intends to avoid severe late complications and to protect all uninjured lung areas for an adequate gas exchange in case of associated lung contusion. In patients with thoracoabdominal injuries, whether to perform thoracotomy or celiotomy first must be decided for each individual case depending on the urgency. The clinical course of a patient, who after a traffic accident suffered from main bronchus rupture, bilateral lung contusion, liver rupture and multiple fractures of the upper extremities illustrates these problems.