Bronchogenic cysts should be completely removed. Small communications with the tracheobronchial tree occur, but extensive involvement is rare. A case of bronchogenic cyst replacing the carina and the medial wall of the right and left main bronchi is presented. Resection and reconstruction was accomplished by using a pedicled pericardial patch to close the defect created by removal of the bronchogenic cyst. Follow-up at 2 years shows an excellent result.