Tracheostomy is an operative procedure that creates a surgical airway in the trachea to bypass an upper airway obstruction and remains a very important life saving procedure worldwide. The present study was conducted to determine the indications and complications of tracheotomy performed among Ear Nose Throat (ENT) patients at Khartoum teaching hospital in Sudan. This was a five-years retrospective study, which was conducted at ENT Khartoum Teaching Hospital in Sudan from June 2002 to September 2007. Data were retrieved from patients’ files kept in the Medical Record Department through a well-designed data sheet. A total of 160 cases were studied. The overall male to female ratio among patients who had tracheostomy was 1:2.8. The majority of patients were between 21-60 years of age. The most common indication for tracheostomy was hair dye poisoning leading to angioneurotic edema in half of the patients, followed by head, neck and chest trauma in 15.6% of cases secondary to Road Traffic Accident (RTA) and industrial injuries involving specially the neck, where laryngeal framework was destroyed. The majority of tracheostomies (88%) were performed as an emergency. No significant complications post tracheostomy other than tube blockage or insignificant surgical emphysema. Mortality rate is 7.5% and it was due to complications other than tracheostomy procedures. Hair dye poisoning leading to angioneurotic edema was the most common indication for tracheostomy in our hospital especially among female. Tracheostomy is still an emergency life saving procedure in the surgical management of airway. Mortality rate among tracheostomiezed patients was high and it was due to the complications other than tracheostomy procedures. Authorities should prohibit hair dye from the local markets, which had been used for intentional suicidal dye poisoning in order to prevent angioneurotic edema. ENT specialist should encourage early tracheostomy whenever indicated and emphasize more in conducting postoperative tracheostomy care by skilled and trained staff. Health authorities should invest more in training all of the doctors in the emergency tracheostomy procedures, in addition to the complications that lead to increase rate of mortality among tracheostomiezed patients.