Objectives: Pulmonary artery sling frequently accompanies various degree of tracheal stenosis. We reviewed our surgical outcomes of pulmonary artery sling from 2 institutions. Methods: From January 1993 to April 2011, 16 patients, who were diagnosed as pulmonary artery sling with or without accompanying other congenital intracardiac anomalies, underwent surgical treatment. Median age and body weight at the operation was 6.2 kg (3.4~17 kg) and 5.4 years old (0.6~45.1 months). Thirteen patients showed preoperative respiratory symptoms such as recurrent airway infection or dyspnea and 3 of them received ventilator therapy preoperatively. Most of patients showed mild to severe tracheal stenosis (14 of 16, 87.5%). Left pulmonary artery re-implantation was performed in all patients; however, an accompanying tracheoplasty was performed in only 2 patients in this study (1 patch augmentation, 1 sliding tracheoplasty). In the immediate postoperative period, we tried to wean ventilator as early as possible, and applied aggressive airway management with nebulizer and physiotherapy. Results: We have 2 operative mortalities. The causes of death were cardiac tamponade due to postoperative bleeding, and aggravation of preexisting multiorgan failure from preoperatively repeated respiratory arrest. There were 2 late mortalities, which were due to airway obstruction by recurrent growing granulation tissue at the tracheoplasty site, and pneumonia, respectively. Living 12 patients, including 11 patients who did not undergo tracheal surgery in spite of various degree of airway stenosis, showed clinically no significant airway problems at their last follow up. Conclusions: Surgical outcomes of pulmonary artery sling without tracheoplasty was acceptable in our study. We think that tracheoplasty may be avoided by intensive immediate postoperative care such as massive physical lung care or nebulizer therapy in many patients with pulmonary artery sling. However, airway infection can be very risky to these patients; therefore close observation and aggressive treatment may be necessary.