This study done in the department of ENT, Medical College Kottayam during the period January 2002 to August 2004 was a prospective analysis of 150 patients of all ages and both sexes presenting to the department for whom Tracheostomy was done for various reasons. The aim was to study the incidence of complications of Tracheostomy and do a statistical analysis and to suggest measures to prevent the same. The incidence of complications was 43.3% with no mortality, the commonest complication being per–operative bleeding. The common indication was malignancy (77.3%) of which laryngeal malignancy accounted for 87.7%. Glottis carcinomas accounted for 79% of laryngeal malignancy. We concluded that all complications are preventable and the best method of prevention is early intervention