We report our 20 year experience with bronchial sleeve resection for endobronchial neoplasms. Among 832 patients who underwent resection procedures, thirty-four underwent a bronchial sleeve resection (4.1%): 27 bronchogenic carcinomas out of 780 (3.5%) and 7 carcinoids tumors out of 52 (13.4%). Bronchial sleeve resection is an appropriate treatment for neoplasms with low grade malignant potential and selected cases of bronchogenic carcinoma (tumor invading the adjacent main-stem bronchus without large hilar extension), especially for patients with compromised pulmonary function. There were no operative deaths; but minor complications occurred in 20% of patients without any major complications. Sleeve resection is a safe and adequate resection therapy for tumors with low-grade malignant potential and for selected cases of carcinoma.