We describe the first case of endotracheal rheumatoid nodules in a 45-year-old Chinese man with rheumatoid arthritis. He developed exacerbation of polyarthritis, new subcutaneous nodules and fibrosing alveolitis. At bronchoscopy, four whitish nodules were detected at the tracheal wall, and biopsy showed fibrinoid necrosis, palisaded inflammatory cell infiltrate and vasculitis, consistent with rheumatoid nodules. Both tracheal and subcutaneous nodules regressed with orally administered prednisone.