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Lung cancer is the main malignancy with frequent endotracheal and endobronchial dissemination. Extrapulmonary sources of airway metastasis are less common, predominantly seen with breast, colorectal, and renal neoplasms. Head and neck cancer represents only a small fraction of tumors with tracheal luminal metastasis. We present 2 such rare cases with F-18 FDG PET/CT imaging. These 2 companion cases show in one instance an obvious hypermetabolic endotracheal lesion and in the other one a discrete airway metastasis overlooked by chest CT and diagnosed by PET with coregistered CT.