Background: Changes of the anatomy of the trachea occur during aging and as a result of a large goiter, cardiac or pulmonary diseases and smoking. These changes may cause difficulties in endotracheal intubation. Methods:In this retrospective study, we analyzed the frequency of acquired deformations, as seen in chest CT scan of 200 adult patients. The radiographic findings were studied, as well as the patients' demographic variables and comorbidities.Results: Acquired deformation of the trachea was found only in patients that were older than 50 years. In 117 patients 50 to 90 year-old three types of deformations were found: "S-shape" trachea in 83 patients (71%), horizontal left main bronchus with wide angle main carina in 24 patients (20.5%) and saber-sheath trachea in 10 patients (8.5%).Conclusions: Acquired deformation of the trachea is frequent in patients older than 50. Studying the patient's chest CT scan may assist the physician in performing endotracheal intubation cautiously and safely.