Nonintubated airway surgery is an innovative procedure for tracheal tumors or stenosis. It avoids intubation and the interference of cross-field intubation, reducing airway trauma and postoperative complications. Utilizing supraglottic devices and short-acting anesthetics, it maintains spontaneous ventilation, facilitates surgery, and enhances recovery after surgery. Various surgical approaches are tailored to the airway lesion's location, and surveillance bronchoscopy, computed tomography (CT), MRI, and PET/CT are crucial for postoperative monitoring and outcome evaluation.