Tracheobronchial injury is a rare but potentially fatal complication of blunt chest trauma. Delays in diagnosis may occur because the signs are nonspecific and these injuries are infrequent. This case report describes a patient who experienced blunt chest injury with a resulting left main bronchus rupture that was not initially diagnosed. The most challenging aspect of reconstruction surgery for tracheobronchial rupture is to design an effective ventilation method during operation that does not interfere with surgical exposure and allows adequate ventilation. Communication with the surgical team and careful planning of all surgical details are important. We review our experience, the ventilation technique and anesthetic problem encountered in the patient undergoing bronchial reconstruction.