A prospective study was undertaken to compare, in intensive care patients, the safety and utility of a percutaneous tracheostomy teehnique with a surgieal tracheostomy technique. Between March of 1992 and June of 1993 we randomly selected 40 patients of the many who were in need of a tracheostomy. After dividing those patients into 2 groups, we per- formed the procedures. Twenty patients received a standard surgicsl traeheostomy, the other twenty received a percutaneous tracheostomy. We found complications occurring in 6 patients who received the standard surgical tracheostomy while only 1 patient suffered complications from the group having the percutaneous tracheostomy. The most common complications being subcutaneous emphysema, pneumothorax, pnemonia, and hemorrhage. Post-decannulation scar was 3.286+/-1.204mm in percutaneous group, 20.36+/-7.26mm in standard group. In comparison to standard surgical tracheoatomy, percutaneous tracheostomies were rapidly and easily performed and asaociated with significantly fewer complication and small post-decannulation scars.