Abstract : <p>Tracheostomy is a common procedure performed in critically ill patients requiring prolonged mechanical ventilation for acute respiratory failure and for airway issues. It is commonly performed to assist in weaning patients from mechanical ventilation or in patients requiring prolonged mechanical ventilation. The objective of the study is to assess the etiology of indications for performing tracheostomy in patients admitted in a tertiary health care center. The most common indication for tracheostomy is upper airway obstruction (48%) secondary to neoplastic causes (54%), followed by upper airway obstruction secondary to deep neck space infections (34%). Predominant age group was seen to be 61-75 years. Tracheostomy still remains a lifesaving procedure in the surgical management of airway if performed timely despite its few complications. Key Words- Tracheostomy, airway obstruction, ventilation.</p>