Carinal resection is defined as the resection of tracheal-bronchial bifurcation with or without associated lung resection. It is usually indicated in case of primary tumors with limited involvement of the carina. The reported mortality ranges from 3% to 20% in high-volume centers. The surgical approach depends on the location of the lesion. Surgery for carinal pathology is technically difficult and the development of anastomotic complications such as devascularization, separation, and stenosis may be directly related to surgical technique.