Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 5 2022 01 17 214 217 Reza Ershadi Department of Thoracic Surgery, Valiasr Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2020 12 06 2020 12 13 Tracheal injuries are relatively rare; however, their mortality rate is relatively high. Complete disruption of the trachea is extremely rare, and a systematic approach is required for early diagnosis and favorable outcomes. This is a case report of a 17-year-old male admitted to the emergency room after a motor vehicle accident. He was agitated and in respiratory distress with labored breathing and urgently intubated orotracheally. In the first flexible bronchoscopy, the diagnosis of the tracheal transaction was missed. Due to saturation drop and high peak ventilator pressures on the seventh day, the flexible bronchoscopy examination was performed in the operating room. This measure revealed complete tracheal transection in midportion. Neck exploration demonstrated complete tracheal transection. The area was debrided, and primary end-to-end anastomosis was performed. The patient was extubated at the end of the surgery. https://crcp.tums.ac.ir/index.php/crcp/article/view/428