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Percutaneous dilatation tracheostomy (PDT) is mostly performed in critically ill patients on intensive care units. The authors describe two cases of tracheal damage following PDT. Haemorrhage requiring surgical treatment with later unilateral recurrent laryngeal nerve palsy and persisting tracheal perforation occurred in one patient. Severe tracheal stenosis after PDT developed in another patient. The authors discuss the risks and benefits of standard surgical tracheostomy and PDT. Treatment options for the management of complications such as tracheo-cutaneous fistula, tracheomalacia and tracheal stenosis are mentioned. [ABSTRACT FROM AUTHOR]