The clinical, radiologic, and pathological features of tracheopathia osteoplastica are reviewed and three new cases are reported. Tracheopathia osteoplastica is usually not diagnosed until autopsy. However, it may be a surprise finding to the endoscopist and occasionally it may produce signs and symptoms of upper airway obstruction and enter into the differential diagnosis of a tumor of the trachea. The chest radiograph may permit the correct clinical diagnosis to be made. The pathological diagnosis is easy with adequate tissue. Because tracheopathia is a lesion predominantly of old age with little associated morbidity or mortality, the correct clinical diagnosis will prevent unnecessary operation.