Discussion: GPA is an ANCA-associated vasculitis that selectively targets small and medium-sized arteries with a predilection for the respiratory and renal systems. Historically, GPA was fatal within months; contemporary treatments now achieve over 80% five-year survival and 75% complete remission. Despite these advances, relapses occur in 50-70% of cases, some of which result in irreversible disease features. There is limited literature on the prognosis and characteristics of SGS and TBS within the context of systemic inflammatory diseases. These stenotic sequelae of GPA can cause upper airway obstruction and pose life-threatening risks. These stenoses, independent of disease activity, present diagnostic challenges in differentiating active inflammation from scarring. GPA is estimated to involve the tracheobronchial tree in 12-23% of cases. SGS–characterized by a circumferential distribution without calcification–is the most common manifestation. A minority of cases include bronchial involvement and tracheobronchomalacia is rare. Clinical manifestations such as stridor and dyspnea may necessitate urgent interventions, including tracheostomy in severe cases. Although endobronchial disease occurs less commonly, its symptomatology parallels that of SGS. Management of SGS and TBS associated with GPA remains complex, as systemic treatments are often inadequate, and relies on bronchoscopic interventions. Endoscopic interventions, while beneficial, carry a high restenosis rate. Effective management requires dilatation with further local intervention. Local steroid injections, laser therapy, cryotherapy, or topical mitomycin may mitigate restenosis. Preliminary data indicate that adjunctive high-dose corticosteroids during intervention could foster better outcomes, while the benefits of immunosuppressive therapies remain equivocal.