Objective To evaluate the safety and clinical efficacy of airway coated stents for the treatment of airway-thoracostomach fistula under bronchoscopic guidance.Methods 48 cases of airwaythoracostomach fistula were analyzed retrospectively after treatment of airway coated metallic stents.All cases were esophageal cancer after stomach esophagus anastomosis or neck anastomosis surgery.Among the patients,45 cases were malignant airway-thoracostomach fistula and three cases were benign.Results The diameter of fistula orifices was 3 80 mm.A total of 53 airway coated stents (7 Y-shaped,36 L-shaped,and 10 cylinder) were placed.The short-term effect by airway coated stents:nine cases (18.75％) showed complete responses,34 cases (70.83％) showed partial responses,and five cases (10.42 ％) had no responses.The total effective rate was 89.58 ％,and the median survival duration of all the patients was five months.Conclusions The use of airway coated stents is proved to be feasible,safe,and effective for the palliative treatment of airway-thoracostomach fistulas.