Objective The imaging manifestations of 28 Cases of neoplasms of the trachea and main bronchi pathologicaliy wereanalysed, and evacuated the merits and demerits of routine chest film, tomography and CT in the diagnosis of tumors of trachea and mainbronchi and discussed the role of imaging diagnosis. Methods 28 cases with neoplasms of the trachea and main bronchi underwent X - raychest films, tomography and CT, and analysed its signs. Results The imaging manifestation of 28 cases Patients were divided into threepatterns: imtraluminal, wall - thickening, and intra - extraluminal types. there were the difference of benign, malignant and tissue patternsof the tumors, and their imaging signs were different. Conclusions The wall - thicken and intra- extraluminal, two types suggestedmalignancy, but the sessile imtraluminal type was difficult for differentiation between benign and malignant tumors.