Tracheotomy in infants and children has been the subject of controversy in the medical literature. A review of the literature shows pediatric tracheotomy to be a surgical procedure with significant morbidity and mortality. Complication rates are greater in children than in adults. The authors recently experienced a case of difficulity decannulation in a 10 month-old male infant, in which decannulation was performed at 14 months after tracheotomy. Tracheotomy was performed for the maintenance of airway due to severe dyspnea, cyanosis, suprasternal and intercostal retraction under the diagnosis as acute laryngotracheobronchitis. So authors report this case with review of literature.