Tracheostomy is a life saving and important surgical procedure throughout the world from long since. Minimum number of study were conducted on tracheostomy in our setting. Based on number, probably Dhaka Medical College Hospital is one of the top institute in the world, where highest number of tracheostomy is being operated (3-10 per day). So, our purpose of this study is to describe our own experiences, regarding indication, complication , decanulation, morbidity and mortality following tracheostomy and to compare the results with the institutes of other countries of the world. Methods It is a prospective observational study, conducted at Dhaka Medical College Hospital from July 2014 to June 2019. Data were collected from the Registers of emergency and elective operation theatre, indoor, intensive care unit (ICU) and medical record room (where file of all patients are being kept for long time). SPSS software was used for data processing and analysis. Prior to the study ethical approval was obtained from Ethical review committee. Results Total 257 patients were selected for the study. Among them 210 (81.71%) were male and 47 (18.29%) were female. Most of the patients were elderly, above sixty years. Commonest indication for tracheostomy were upper airway obstruction due to laryngeal or other head neck cancer in 70.04% of patients. Next important indication was upper airway obstruction due to trauma in 24.9% cases. Most of the time (82.88%) we had to perform Emergency tracheostomy. Longitudinal or