Aims and Objectives: To study the indications, timing and complications of tracheostomy in intensive care unit patients and to compare early versus late tracheostomy outcomes. Materials and Method: Studied 120 patients undergoing open surgical tracheostomy in ICU. Results: Majority of the tracheostomies were performed early, that is within five days of endotracheal intubation and none of the patients were kept intubated for more than 15 days. The commonest indication for performing a tracheostomy was anticipated prolonged intubation. The early complications most frequently faced with were bleeding and tracheostomy tube blockade. Lower respiratory tract infection was more likely in patients with prolonged intubation periods especially if more than 10 days of intubation. Discussion: The average duration of stay in the ICU following a tracheostomy was shorter when an early tracheostomy was performed and the mortality rate was also found to be less in patients undergoing an early tracheostomy. Conclusion: For patients who are predicted to be on ventilator for a longer period; it is certain that an early tracheostomy does improve the outcomes of the patients.