The Montgomery T tube is a device which will be used as a combined tracheal stent and an airway after laryngotracheal surgery.The device is used mostly in specialized centres for head and neck surgery and therefore many anaesthetist may be unfamiliar with its use. Removing the T tube is more complicated as inserting it as the airway might collapse and securing the airway will be impossible. The choice of airway maneuvers must be individualized depending on the severity of the stenosis and experience of the anaesthetic team We have reported a case of 15yr old female o/c/o tracheal stenosis due to prolonged intubation with tracheostomy and T-tube insitu came for T-tube removal with a brief review of airway management options