Central airway obstruction commonly occurs in thoracic malignancies. Treatment is usually palliative but may be significantly challenging. Several endoscopic interventions are available to establish airway patency; however, their use is sometimes limited by certain factors like availability and high oxygen requirement. Cryosurgery has been established as a safe and effective technique for treatment of malignant airway obstruction, but its use has been limited to being adjunctive to other modalities and to low-grade stenosis. This is mainly due to the delayed effect and inability to achieve immediate airway patency. We report the successful use of this technique as stand-alone modality in a tracheal tumor with severe obstruction leading to acute respiratory failure. Immediate recanalization was achieved resulting in rapid resolution of symptoms.