The patient was a 76-year-old man who was transferred to our department following the diagnosis of tracheal cancer. After transfer to our hospital, complete atelectasis of the left lung was confirmed during the preoperative examination; therefore, emergency surgery was decided for life-saving purposes. The surgery was performed under extracorporeal membrane oxygenation (ECMO). Carinal resection was conducted via right-sided thoracotomy, and double-barrelled reconstruction was performed. After the surgery, postoperative complications, such as aspiration pneumonia, interstitial pneumonia, and anastomotic dehiscence of the carina, were noted, and perioperative management was challenging. Nonetheless, the patient was safely transferred approximately 4 months after the surgery. It is rare to have an emergency operation that requires carinal reconstruction; thus, we present this case along with a review of the literature.