We aim to report our experience of infant tracheostomies in a period of 10 years and discuss the indications, complications, outcome, and follow-up. This case series will contribute to the data of shifting trends in paediatric tracheostomy indications and outcomes. This study aims to review the indications, complications, and outcomes for paediatric tracheostomy at Hospital USM. A retrospective evaluation of the last ten years of experience at Hospital USM for all infants under the age of one who undergoes tracheostomy from January 2011 to January 2021 was undertaken. During the research period, twelve tracheostomies were performed. Complete data were available for all patients. There were 8 (67%) males and 4 (33%) females. The patient's age at the time of tracheostomy ranged from one day to nine months, with the mean age of tracheostomy insertion being 95 days. The most frequent indication was prolonged ventilation (50%), followed by upper airway obstruction caused by a craniofacial anomaly (33%), subglottic stenosis (8%), and laryngomalacia (8%). Sixteen per cent of patients were successfully decannulated. In newborns, tracheostomy is a life-saving procedure with high morbidity and mortality. The role of tracheostomy in airway management has evolved, both in terms of indication and outcome. This series complemented the current trends in indications of infant tracheostomy.