OBJECTIVE: To explore the correlation between the occurrence and the prevention of complications in childhood tracheotomy. METHODS: A total of 227 cases of childhood tracheotomy were analyzed based on clinical data from March 1974 to July 1999. RESULTS: Of 227 cases, 189 were decannulated successfully. Twenty-three cases discharged with tracheotomy tube. Fifteen cases died of primary disease. Fourteen of 227 cases had complications. Among them, 2 had intraoperative suffocation, 1 had trauma of esophagus, 5 complicated subcutaneous emphysema in cervical region and 1 had mediastinal emphysema. Five of 14 cases had postoperative drop out of the tube, 2 of them died of suffocation. CONCLUSION: The occurrence of complications is related to age, original disease, operative method and nursing.