Percutaneous tracheostomy is a common procedure performed in the intensive care unit setting. This review discusses the evidence behind its use, provides a detailed description of the various techniques, and considers the principles of post-tracheostomy care based upon the National Tracheostomy Safety Project. It also outlines the most recent recommendations for emergency front-of-neck airway access, specifically the indications and technique for surgical cricothyrotomy – an essential skill for all anaesthetists and other emergency airway management practitioners.