Suglottic and upper tracheal stenosis remains the most challenging problem facing the laryngologist. Anterior augmentation with costal cartilage can be used in cases with subglottic and upper tracheal stenosis costal cartilage can be used in cases with subglottic and upper tracheal stenosis in grade ll and early grade lll stenosis. Combined anterior & posterior augmentation used for cases with severe stenosis as advanced grade lll & cases with grad v. But the results are flexible and vary from patienl to other according to the nather of stenosis, grad and length of stenottic segment.