Ob! ruction of the central airways, the trachea and main stem bronchi, may result from many disease processes including malignant growth. It is estimated that in the United States, malignant neoplasms will cause central airway obstruction (CAO) in 80,000 cancer patients a year. 1 lt is estimated that 20% of these patients will experience ignificant morbidity due to per i tent cough, dyspnea, and obstructive pneumonia, and as many as 35-40% of lung cancer patients die due to complications resulting from locoregional disease. 1• 2 While most treatments for malignant CAO are not curative, they have been shown to improve respiratory function, avoid mortality, and improve quality of life. 3.4. 5• 6 Many different strategies for managing malignant airways exist. Choosing the best one depends on patient factors such as presence of co-morbidities, medical stability, the nature of the underlying tumour, and overall prognosis. Non-patient related factors such as expertise of medical staff and availability of technology also greatly impact the mode of treatment chosen. 2 This article presents current treatment options for malignant CAO, specifically, therapeutic bronchoscopy, radiotherapy, and surgical resection.