BACKGROUND: Relapsing polychondritis (RP) is a rare autoimmune disorder characterized by episodic inflammation of cartilaginous tissues. Its diverse clinical manifestations frequently pose diagnostic challenges and lead to misdiagnosis. METHODS: We present a 59-year-old female initially diagnosed with refractory hip osteoarthritis based on persistent left hip pain unresponsive to conventional anti-inflammatory therapy. Subsequent development of stridor and dyspnea prompted comprehensive evaluation, including laryngotracheal imaging, autoimmune serology, and multidisciplinary consultation. Diagnostic criteria for RP were applied in accordance with revised Michet criteria. RESULTS: Tracheal stenosis secondary to tracheal chondritis and iritis were identified, confirming the diagnosis of RP. Following initiation of corticosteroid therapy, the patient exhibited marked clinical improvement. CONCLUSION: This case underscores the importance of enhanced clinical awareness regarding atypical presentations of RP, particularly when accompanied by evolving systemic symptoms. A multidisciplinary diagnostic approach is advocated to facilitate early detection and improve patient outcomes.