Management of tracheostenosis in adult patients who are either medically unreconstructable due to significant comorbidities or surgically unreconstructable remains a challenge. The tracheal T-tube offers an excellent permanent solution to the problem of the unreconstructable trachea. This article reviews 3 patients who underwent tracheofissure and placement of a tracheal T-tube after failed prior attempts at repair of tracheal stenosis. The tracheal T-tubes have been maintained for 13, 15, and 36 years, and these patients have enjoyed adequate phonatory and respiratory functions with the T-tube plugged and functioning as an airway stent. There have been no major complications related to use of the T-tube in this group of patients. The tracheal T-tube is a viable alternative to long-term management of the unreconstructable trachea, allowing patients airway support and adequate phonatory and respiratory function.