A case report of adenoid cystic carcinoma of the trachea is presented. A high index of suspicion is required to make the diagnosis of tracheal tumours early since the patients tend to have normal chest radiographs which on closer examination may show an abnormality of the tracheal column. Adenoid cystic carcinoma is the most common malignant tumour of the trachea. Locoregional control of this disease is achieved by a combined modality therapy of surgery and postoperative radiotherapy. Despite this, it still has a prolonged clinical course and the tendency for delayed onset of distant metastases.