We performed a balloon dilatation without a fluoroscopy monitoring by ultrasound. A 44 year old female patient was presented with subglottic stenosis, due to prolonged intubation. Although she had undergone tracheal resection and end-to-end anastomosis, the tracheal stenosis had recurred. She was scheduled for balloon dilatation. However, fluoroscopic guidance was not available, and thus, we used ultrasonographic monitoring as an alternative method. We performed a transverse scan, just cranial to the suprasternal notch, and we obtained a real time image of the trachea dilated by the balloon. We suggest that ultrasonographic monitoring is a useful adjunct to balloon dilatation in patients with tracheal stenosis.