During ventilatory support via tracheostomy tube, the desire to communicate verbally is common and loss of speech may result in great fear, frustration in the long-term tracheostomized patients. Several methods of communication have been developed in an effort to alleviate this discomfort and anxiety. This case presents our experience of using speaking tracheostomy tube which allowed the patient to talk while on a vetilatior. A small catheter(inner diameter 1mm) which provided an opening with gases flowed upward through the vocal cords was adapted to the standard tracheostomy tube and connected to an oxygen flowmeter(3~5L/min.) with a Y shaped connector for intermittent control. When the open side of the Y connector was occluded, gases flowed into the subglottic area, allowing for vocalization. Though experience with this method was somewhat disappointing than normal sound, their use in long-term and chronic ventilating patients was proved satisfactory.