A 28-year-old man presented with stridor and dyspnoea. Imaging showed a tracheal mass with severe narrowing of the subglottic airway. Histopathology was consistent with non-seminomatous germ cell tumour. The patient underwent cricotracheal resection and reconstruction of the trachea with tracheostomy. Subsequent positron emission tomography demonstrated new right upper lobe nodules. Postoperative chemotherapy was initiated using the VIP regimen (etoposide, ifosfamide and cisplatin). After four cycles of chemotherapy, CT of the thorax showed interval resolution of most of the pulmonary nodules. Thoracoscopy with right upper and lower lobe wedge resections was performed to remove the residual disease. The patient is currently disease-free and undergoing continued surveillance to assess for clinical, biochemical or radiographical evidence of disease recurrence.