Background: Tracheal deviations are encountered frequently in head and neck tumors especially in thyroid cancer. Dyspnea and stridor are symptom calling for surgery. The method of evaluation in tracheal deviation is not well established yet. This paper is aimed to suggest objective tools to evaluate tracheal deviation in relation to cervical vertebra. Material and Method: Ten cases of thyroid cancers were recruited retrospectively. Tracheal inner shadow and shape of cervical vertebra were reconstructed three dimensionally using 3D-doctor to compare position of trachea in relation to vertebral body. Extent of deviation was scored in relation to both lateral borders of vertebral body. Angles between trachea and spinous process were measured in axial CT and compared between study group and control group. Results: Deviation scores were statistically significant between study group (mean=1.1) and control group (mean=0) (p=0.0008). Deviation angles at maximal tumor size in study group (mean=160.3 Degrees) and deviation angles of control group (mean=177.1 Degrees) were statistically significant (p=0.0007). Angles at maximal deviation of three dimensional images ages in study group (mean=162.6 Degrees) and deviation angles of control group (mean=177.1 Degrees) were statistically significant (p=0.0089). Conclusion: Tracheal deviation can be evaluated using scoring of three dimensional images and measuring angle between trachea and vertebral spine.