Abstract: Background: Tracheostomy is the most commonly performed procedure worldwide. It is mainly done in the critically ill patients requiring long term ventilation, facial trauma, laryngeal fractures, laryngeal malignancy, etc. Converting from endotracheal intubation to tracheostomy has many benefits in terms of maintaining the laryngeal function, feeding, safety and it is more comfortable than endotracheal intubation. Tracheostomized patients requires less analgesics and sedatives. It also helps in easier and early weaning from mechanical ventilator, possibility of speech, initiation of oral intake of medication. This all contributes to shorter ICU stay and hospital stay which becomes more cost effective. Methods: This is a prospective observational study that was conducted in the 22 bedded neuro intensive care and medical intensive care unit of Birat Medical College and Teaching Hospital. The data were collected from 1 st Aug 2021 to 28 tracheostomy for prolonged intubation, protection of airway and to maintain tracheobronchial toileting was taking under study. Results: Our study was a prospective observational regarding percutaneous dilatational tracheostomy. A total of 71 patients were included in the study. Out of which 39(54.9%) were male and 32(45.1%) were female with the ratio of (1.2:1). The age of the patients ranged from 18-82 years with the mean age of 53.25. The most common indication of percutaneous dilatational tracheostomy was prolonged intubation and that accounted for 29(40.8%) of the patients which was followed by airway protection 27(38%) patients and to maintain the pulmonary hygiene was seen in 15 (21.1%) patients. Conclusion: Tracheostomy is among the most frequently performed procedures in critically ill patients. Percutaneous dilatational tracheostomy is a safe and feasible procedure performed at bedside with minimal invasive technique in ICU.