Objective In view of the situation that tracheal atrophy causes the overall airway size to become smaller in the elderly, effects of the airway wall surface on reconstruction of a narrow airway and the airflow field under different respiratory conditions were investigated. Methods A three-dimensional (3D) model of human airway was established by using Mimics, and flow field in the airway was simulated by computational fluid dynamics (CFD) method. The inner wall pressure and the distribution of airflow were analyzed and compared under different breathing states. Results Under different respiratory states, the pressure of endotracheal wall was relatively uniform in the endotracheal wall, but decreased significantly in air inlet of the bronchial stenosis segment, and reached negative pressure near the narrowest area. The airflow velocity decreased from the center of the pipe to the boundary layer, and the velocity reached the maximum at the narrow area. Vortex was generated when airflow passed through the narrow area, and the larger the inlet flow velocity was, the larger the positive pressure and negative pressure were, the more obvious the pressure drop at the narrow area was, and the more obvious the vortex phenomenon was. Conclusions The constriction of the airway stenosis area caused by negative pressure will lead to the patient’s dyspnea, and the eddy current will cause the airway wall to be affected by the aerodynamic shear stress and may damage the airway wall mucosa. Therefore, understanding of the pressure distribution and velocity distribution in the narrow airway can provide references for clinical diagnosis and treatment of such diseased airways.