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Ventilation strategies in patients with severe tracheal stenosis should be tailored to the patient according to the underlying cause and narrowing location. This report is on a case of a 68-year-old male patient, who was admitted for radiotherapy because of esophageal cancer and then developed severe stenosis at the cervical trachea. We used venovenous extracorporeal membrane oxygenation to secure the airway and ensure adequate oxygenation. Then urgent endoscopic balloon dilation of airway stenosis was successfully performed under general anesthesia. This case shows that venovenous extracorporeal membrane oxygenation can be used in endoscopic tracheal procedures for patients with severe benign stenosis in the upper-trachea who are unable to tolerate conventional ventilation.