Purpose: The purpose of this study was to conduct a matched pair analysis to assess the impact of radiotherapy (RT) on patients with malignant tracheal tumors using the Surveillance, Epidemiology, and End Results (SEER) database. Additionally, a predictive nomogram was developed for patients with malignant tracheal tumors. Methods: Propensity Score Matching (PSM) was used to minimize bias between the RT and no-RT groups. We utilized both univariate and multivariate Cox proportional hazards regression analyses to identify independent prognostic factors for patients and subgroups. We developed a novel nomogram and evaluated its results using the C-index. Results: A total of 648 patients between 1975 and 2019 were included, and 160 patients in RT were 1:1 propensity score-matched with no-RT. The independent prognostic factors for patients with tracheal malignant tumors were surgery, marital status, disease extension, pathology, and age. The independent risk factors for patients without sur-gery included RT and disease extension. The C-index confirmed that the nomogram accurately predicted the prognosis of patients with tracheal malignant tumors. Conclusions: Our findings suggest that RT may provide a survival benefit for tracheal cancer patients who did not undergo surgery. The nomogram can be a useful tool for predicting prognosis in patients with tracheal malignant tumors.