BackgroundVideo-assisted transthoracic surgery (VATS) is a minimally invasive procedure that has been reported as a valid method for tracheal resection and reconstruction. However, for patients with tracheal tumors, one-lung ventilation during VATS is difficult to achieve, and utilizing a double-lumen tube is not applicable in these types of situations. When using a bronchial blocker, a fiberoptic bronchoscope is required to verify the position of bronchial blocker, though the repeated use of the fiberoptic bronchoscope increases the risk of tumor rupture and hemorrhage.Case presentationWe report a case with a middle tracheal tumor received tracheal resection and reconstruction under VATS, in which VivaSight single-lumen tube guided bronchial blocker placement was used for achieving one-lung ventilation. The VivaSight single-lumen tube can provide real-time and continuous monitoring of the position of bronchial blocker. Moreover, it does not require the aid of fiberoptic bronchoscopy.ConclusionsVivaSight single-lumen tube combined with a bronchial blocker is a feasible choice for one-lung ventilation in this type of surgery.