Indication for paediatric tracheostomy has changed. Upper airway obstruction secondary to infectious disorders is no longer for commonest indication. The aim of this study was to establish data on indications, outcome and complications of paediatric tracheostomy. A retrospective analysis of paediatric tracheostomy carried out between March 2002 to March 2004 was done. 18 patients were identified. The commonest indication was prolonged ventilation (94.5%) followed by pulmonary toilet (5.5%). None was performed for upper airway obstruction. Post-operative complications were encountered in 6 patients (33.3%), the commonest being accidental decannulation notably in children less than six years of age. 12 patients (66.6%) were successfully decannulated. The mortality rate was 16.6%. All death were non-tracheostomy related. The commonest indication for tracheostomy was prolonged ventilation and tracheostomy in children is relatively safe despite complications.