A retrospective study analyzed 45 patients with benign subglottic stenosis treated with Montgomery T-tube placement. Etiologies included iatrogenic causes in 41 patients (91.11%), including posttracheotomy stenosis in 29 (64.44%) and postintubation in 12 (26.67%), post-traumatic in 1 (2.22%), post-tuberculosis in 2 (4.45%), and associated with COPD in 1 (2.22%). All patients underwent the procedure successfully, with 39 (86.67%) achieving permanent airway patency and restored voice function. Six patients (13.33%) had retention failure within 2 weeks due to granulation tissue or mucus plug. Short-term complications included subglottic edema in 31 (68.89%), mucus plug obstruction in 24 (53.33%), and granulation tissue proliferation in 10 (22.22%). Of the 39 successful patients, 14 (35.9%) were decannulated with long-term stability, the mean tube retention time was 20.5 months, and 25 (64.10%) required long-term retention. A higher Cotton-Myer grade was associated with a lower likelihood of decannulation (OR = 0.168, 95% CI: 0.031–0.920, P < 0.05).