Emergency tracheostomy has long been used for acute upper respiratory obstruction, regardless of the cause.1 Elective tracheostomy, in our hands, has also proved to be a very useful procedure. It has been of considerable value in the management of patients with head injuries, high spinal cord injuries, and chest injuries. It has also been used in situations where the patient had difficulties with respiration or in clearing the tracheobronchial secretions. The purpose of this investigation was to determine the hazards or complications of tracheostomy, the frequency with which these complications occurred, and, last, to determine what steps might be taken to avoid these complications. A review of tracheostomies performed at our hospital showed that 23 complications occurred in the last 80 tracheostomies done. This is an incidence of 28%. The complications encountered are shown in the Table. The complications are listed in their order of relative frequency. Sixty-one tracheostomies