Early attempts at tracheal resection were timid, limited to 2 cm or less of the trachea and frequently less than circumfer- ential. More extensive resections were attempted, exploring the use of various prostheses and homograft techniques. The results with such techniques were poor, adversely affected by failure of healing and granulation tissue ingrowth. The mod- ern era of tracheal surgery began when Hermes. C. Grillo and colleagues undertook a series of cadaveric studies to estab- lish the length of trachea that could be safely resected with end-to-end anastomosis. These studies were confirmed by a surgical series in which he and F. Griffith Pearson developed and expanded surgical techniques. These pioneers estab- lished the general principles of this surgery; the length of trachea that could be safely resected; and the ancillary meas- ures required, allowing tension-free anastomosis. Although some have tried to extend these limits by developing newer prosthetic materials, these have not proven to be safe.