Tracheal perforation following endotracheal intubation is an underestimated complication that seriously compromises prognosis. Treatment can be either conservative or surgical, depending on the lesion and the patient's clinical condition. In this case report, we describe a patient in whom tracheal perforation occurred during double-lumen tube placement for elective surgery on a pulmonary nodule. As the perforation was accessible to the surgeon, a running suture could be made from the oesophageal wall.