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Anomalies of the trachea and bronchi are rare but clinically significant conditions that can complicate respiratory management and pose challenges during surgical interventions. These congenital and acquired abnormalities affect the structure and function of the airways, leading to varying degrees of respiratory compromise. Common anomalies include tracheal stenosis, tracheal diverticula, bronchial atresia, and bronchial malformations such as bronchogenic cysts. The clinical implications of these anomalies depend on their severity and location but often necessitate specialized diagnostic and therapeutic approaches. This article explores the various types of tracheal and bronchial anomalies, their impact on respiratory function, and the strategies for managing these conditions in both pediatric and adult populations. Additionally, it highlights the importance of advanced imaging techniques and surgical interventions in the treatment of these complex airway malformations.