Vagal nerve schwannomas that compress the trachea are extremely rare. We report a case in which a giant middle mediastinal schwannoma accompanied by severe tracheal stenosis was excised. A 70-year-old woman had a 30-year history of hoarseness and paralysis of the left recurrent laryngeal nerve. She presented with chronic cough and dyspnea, which she had experienced for several months. Computed tomography indicated a middle mediastinal mass (8.3 × 7.1 × 4.9 cm) that directly compressed the lower trachea, carina, both bronchi, and the left main pulmonary artery. The trachea was 4 mm in diameter at the narrowest point. Through a median sternotomy, the superior vena cava, ascending aorta, right pulmonary artery, and trachea were dissected, and the tumor was excised by gentle dissection. Histologic examination indicated a benign schwannoma.