Tracheostomy is a common procedure in critically ill patients requiring prolonged mechanical ventilation. The use of tracheostomy can facilitate weaning from ventilation and potentially increase the availability of intensive care unit (ICU) beds. When the COVID-19 pandemic spread all around the world, ICUs had a massive influx of critically ill patients, many of whom became candidates for tracheostomy. Tracheostomy is an aerosol-generating procedure that exposes physicians at high risk to contract infections. In COVID-19 patients, healthcare workers who do tracheostomies must take into account additional considerations associated with the infectivity of SARS-CoV-2. Recent reports suggested to perform surgical and percutaneous tracheostomies with modified techniques to minimize the aerosol and then to keep the personnel safe.