Endobronchial Nd:Yag laser therapy is an excellent tool to reopen the central airway(s) in patients with severe respiratory symptoms caused by endobronchial tumor growth. Rigid bronchoscopy should be the method of choice. Usually general anesthesia is necessary. Complication rate depends on the condition of the patient, the localization of the tumor, patient selection criteria, method of endoscopy, method of anesthesia, method of laser energy application, and last but not least, the operator's skills and the treating team's cooperation. A very careful monitoring of the patient's condition during and after the operative procedure is mandatory. Only when all these conditions are fulfilled can endobronchial Nd:Yag laser therapy have a great benefit for the patient with a low grade, acceptable complication rate.