A rare case of a patient with primary adenocarcinoma of the middle lobe bronchus that was successfully treated with rigid bronchoscopy followed by middle sleeve lobectomy is reported. The patient was a 75-year-old man who presented with low-grade fever and cough. Chest computed tomography showed obstructive pneumonia of the lower lobe and a polypoid lesion in the truncus intermedius. Middle sleeve lobectomy and mediastinal lymphadenectomy were performed following recovery of respiratory function after partial resection of the tumor with rigid bronchoscopy. There was no sign of tumor recurrence and metastasis over 32 months of follow-up. We should be aware of tracheal or bronchial tumor in patients with prolonged asthma-like symptoms. Palliative resection with rigid bronchoscopy was useful to make the correct diagnosis, evaluate the extent of the tumor, and protect the right lower lobe.