The indications for percutaneous tracheostomy (PT) are the same as those for conventional tracheostomy. First described in 1969, PT has gradually become more widely used. We analyze the first 10 cases in which the procedure was performed in our postoperative intensive care unit. PT was performed in 10 patients admitted to the postoperative intensive care unit needing tracheostomy, following the procedure of Cook (Bjaeverskov, Denmark). Complications appearing during the procedure or later in the study period were recorded. All 10 PT procedures were successful. The mean time was 11.9 min (+/- 5.9). Minor complications developed in 5 patients. In 3 of these, the problems were technical (stylete slipping out, cannula hitting the endotracheal tube, and difficult insertion of a prepared cannula). The other 2 complications were small hemorrhages in the tracheostomy. No episodes of hypoxemia occurred during PT. The only late complication was a tracheostomy infection in a patient. In our experience PT is a useful alternative to conventional tracheostomy. The technique is easy to learn and performed quickly. Complications that develop do not affect the ultimate success of threaten patient stability.