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Conventional silicone airway stents are effective in relieving stenoses but are prone to complications such as migration and granulation tissue formation. These complications reduce patients' tolerance and induce unwanted procedures, limiting their overall benefit. Over the past decade, personalised, three-dimensional (3D)-printed silicone stents have emerged as a possible solution to some of these concerns. In this narrative review, the authors aim to guide the physician into understanding the relatively straightforward creative process behind 3D stents and the selection process of the best patients for their use. Current use is limited to complex anatomical airway stenoses, but more indications could blossom from future trials as technology, expertise and access develop going forward.