Resection and reconstruction of the carina is a complex and rare surgical procedure with higher postoperative complications than standard resection, which is a great challenge for thoracic surgeons. Such tumors are more common in the central lung cancer involving the main bronchus and primary carcinoma of the carina. These patients often require pneumonectomy during carinal resection with complicated reconstructive efforts to establish airway continuity. Thus, strict patient selection, appropriate operation plan, proper perioperative care and execution by both thoracic surgery and anesthesia teams are required for optimal results. The aim of this thesis is to summarize the surgical technique and perioperative management of carinal resection and reconstruction in the treatment of airway malignancies.