Ciaglia et al first reported percutaneous dilatational subcricoid tracheostomy in 1985. We are now reporting the results on 165 patients with follow-up on 52 patients who went on to decannulation. Our technique has been slightly modified and these points are emphasized. To date, there have been no significant perioperative or postoperative complications and no long-term complications on 52 patients who were followed clinically, postdecannulation, for from four months to five years. The procedure is recommended as simple, safe, and cost-effective. We feel it is the technique of choice for routine elective tracheostomy.